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Welcome BBC Readers!

February 9, 2012

Welcome to Fierce, Freethinking Fatties!

If you’re new here, then you probably read about us in this BBC news story. You’re also probably wondering why the hell we’re so proud of being fat.

Well, for one, we’re not proud of being fat. We’re proud of being kickass, awesome people who just happen to possess a few more fat cells than most. But what makes us awesome is not that collection of fat cells, but the people behind the fat cells who society neglects in the pursuit of “health.”

By the current, socially-accepted definitions of health, thin=healthy and fat=unhealthy.

We disagree. We believe that health lifestyles=health and unhealthy lifestyles=unhealthy, but even that is subject to the whims of genetics, the social determinants of health and just plain luck.

But lifestyle choices are more than just what we eat and how active we are. People have the choice of whether to smoke or not, drink or not, go tanning every day or not. All of these choices, along with diet and exercise habits, contribute to your overall health matrix. Focusing on any single risk factor is penny wise, pound foolish.

But we understand the desire to address obesity. The media is filled with stories of the ravages of obesity. So, you come here and you want to know how we respond to the health issues associated with obesity.

Fair enough.

Behind the scenes in the medical community there is a seismic shift taking place. Dieting has a well-documented history of failure rate, and the repeated attempts to lose that weight, followed by its inevitable regain, is known as weight cycling, the health risks of which broadly accepted (PDF).

Yet physicians continue to recommend weight loss as the “cure” for obesity despite no evidence that long-term weight loss is sustainable for the vast majority of people. Instead, physicians are recommending a modest weight loss of 5-10% of your starting weight. For a 5’7″, 265 pound guy like me with a BMI of 41.5 (aka morbidly obese), that shakes out to a weight loss of 13-26 pounds. At a weight of between 239 and 252, that gives me a BMI of between 37.4 and 39.5, on the cusp of morbid obesity.

I still look fat, but that little bit of weight loss has made a profoundly positive impact on my health. Why? Is it because I have five less pounds of fat cells on my body?


If that weight loss occurred because I transitioned from an energy dense diet and sedentary lifestyle to a diversified, healthy diet and an active lifestyle, then this may effect my weight, but the loss of the weight itself has little to do with the actual health improvements. What matters are the lifestyle changes I have made, which may, or may not, result in a 5-10% weight loss or more or less.

By hyperfocusing on the importance of weight loss, we have done a disservice to the true goal of healthcare: making us healthy. If we follow the evidence — evidence like the decades of work behind Dr. Stephen Blair’s fitness research — we find that weight loss is not necessary to improve one’s health, but lifestyle changes are.

This approach to healthcare has a name: Health At Every Size® (HAES), and it is an evidence-based approach to healthcare that focuses on emphasizing lifestyle changes and deemphasizing one’s weight status.

“But if you don’t look at the scale, how do you know if it works?” This question stems from a weight-based metric of health. In this model, fat is the disease-causing agent and losing fat is the cure. But the propensity of research does not support this model.

In the world of research, the true disease-causing agent is insulin resistance (IR), or the body’s inability to process one’s blood sugar. If left unchecked, IR can ravage the body, triggering a whole host of metabolic disorders that can lead to impaired morbidity and mortality. IR is a greater indicator of risk for heart disease, type 2 diabetes, hypertension and, yes, obesity.

But not all obesity is caused by IR. We also live in a world where poverty and education, medication, chronic stress, lack of sleep and our newly emerging understanding of endocrine disruptors in the environment have all been implicated in rising obesity rates. And you know what else has been implicated? Weight cycling.

That’s right: dieting leads to weight cycling leads to long-term weight gain.

By taking the focus off of weight and putting it where it belongs — onto IR — HAES offers a reasonable alternative for people who are looking to get healthy and who aren’t interested in jumping back on the diet bandwagon.

HAES has three basic tenets.

  1. Eat a healthy and diverse diet, paying attention to your body’s natural cues of satiety and craving
  2. Move your body in a way that you enjoy and that is sustainable
  3. Love your body as it is

Now, before you dismiss me as a crackpot hocking a new diet fad, a similar approach to healthcare has been advocated by none other than Surgeon General of the United States, Regina Benjamin:

And the national media is beginning to take notice, including the National Geographic and MSNBC. And unlike the traditional weight-based focus on healthcare, HAES has a growing catalog of research that positive long-term health outcomes for its adherents, regardless of weight.

But you’re still skeptical. I completely understand, and I, and my fellow bloggers, are always open to questions, comments and criticism, so feel free to challenge us below.

One word of caution, though: we don’t call ourselves Fierce, Freethinking Fatties for nothing. Any abusive or disrespectful comments will be subject to the Asshole Rule. If five people tag you as an asshole, your comment will be deleted. If you have three comments deleted, you have earned yourself a permaban. So, by all means, ask questions, just don’t be a douchebag about it.

Finally, if you want to learn more about HAES, please visited the Association of Size Diversity and Health, a coalition of healthcare professionals who are committed to spreading the word about HAES. There’s even a great blog filled with excellent resources.

And finally, just to quell that nagging feeling that we must be selling something, there’s a book called “Health At Every Size” written by Dr. Linda Bacon (we know, ha ha, bacon), which reintroduced the concept of HAES and has an incredible amount of research and information on how you can incorporate HAES into your life.

Thank you for visiting us today, and if you have a moment, please consider donating to our billboard campaign to combat the effects that the Strong4Life campaign has had on the children of Georgia.

Thank you.

Shannon Russell
Chief Fatty at Fierce, Freethinking Fatties.

139 Comments leave one →
  1. Fab@54 permalink
    February 9, 2012 10:25 am

    Just a minor typo… I’m assuming
    “By the current, socially-accepted definitions of health, thin=healthy and fat=healthy.”
    was meant to read “….fat = unhealthy.” Other than that, *Thumbs Up!*

  2. Joe permalink
    February 9, 2012 10:30 am

    60% of Americans are “obese”–Health care to CARE FOR THESE FOLKS is bankrupting the system… How about you who CHOOSE TO BE FAT, then pay a larger share of the health care costs associated with your “life style choice”… Yup, bury your head in the sand… cry out for “justice”… When I haul your FAT body into the hospital AGAIN because your type 2 is kicking up, or you have a heart attack at 55, or your no longer can walk 1/2 a block–yup, something to strive for

    • Fab@54 permalink
      February 9, 2012 10:48 am

      Skyrocketing health care costs due to fat/obese people is a myth. A big LIE.

      There are studies that show that a majority of obese people avoid all sorts of health care opportunities because they have been made to feel ashamed of themselves, and unworthy of real, competent health care services.
      They avoid doctors and clinics to avoid the lectures and the dismissing of concerns and complaints they may have about their health and/or pains they suffer.

      Know where those “health care costs for obesity” stats come from?
      From doctors, ER nurses, and clinics who note “obesity” on every goddamn page of every fat patient’s medical file, and on every freakin’ script for blood work or tests – even if those lab work-ups or tests have absolutely NOTHING to do with a patient’s weight.
      That’s where those bullshit stats come from. It’s called “Eyeball Diagnostics”.

      And I know, because I see it time and time again on my scripts for blood work every 6 months. (I have psoractic arthritis and hypothyroidism).
      It pisses me off, because my health issues are NOT in any way due to my weight, (as a matter of fact, more than likely my obesity is a symptom of my conditions!) and I have never EVER sought any sort of health care advice or treatment for my weight– never even asked for a ‘diet or nutritional plan”. But there it is – in big, bold letters along with other diagnostic results every goddamn time: “Obesity”.
      It’s all bullshit.

    • February 9, 2012 10:58 am

      Joe, obesity is not bankrupting our healthcare system, it is the privatized, for-profit design of healthcare that is bankrupting our healthcare system. Per this article:

      Obesity itself is not driving medical spending.. Indeed, even if, by some miracle, we suddenly understood the multiple causes of obesity, and as a result, the share of adults who are seriously overweight plummeted from 28 percent to 20 percent over the next decade , CBO researchers calculate that per capita spending still “would increase to $7,230 in 2020—[only] about 4 percent less than spending in the first scenario”– which assumes that the percentage of American who are obese remains at 28 percent.

      If you want to vent your frustration with fat people, fine, but at least try to stick to the facts.

      I take it you’re an EMT, based on your comment about hauling my fat body. Is this how you see your patients? You begrudge them because of poor lifestyle choices? Do you get equally angry at the lifetime smoker who has collapsed due to emphysema? Or how about the 20-year-old kid who got drunk and ran his car into a tree paralyzing himself? Do you grumble about what a jerk he is for costing you so much money?

      If you do, then I seriously suggest you find a new career.


    • February 9, 2012 11:11 am


    • Angie permalink
      February 9, 2012 11:48 am

      I tag thee an asshole.

    • February 9, 2012 11:51 am

      Joe, I know it is challenging but I invite you to do a little research and site your sources as is common practice amongst the folks that support a compassionate and supportive methodology (Health at Every Size) to looking at this problem. Your accusations are not based in fact, they are based in the moral panic that is at the center of the bigotry and hatred of folks who are fat. If you are interested in spouting hatred and stigma, you will find many that will join with you, but here you can expect your hatred to be met with fact based, scientific data, peer reviewed published studies that illustrate the harm your hatred contributes to. Based on the tone of your comment, I think that your hate may have too great a hold on you, but stick around, we would love to help you see the error in your thinking. Just remember that civility is required if you want to stay around.

    • Linda permalink
      February 9, 2012 11:56 am

      also would like to tag asshole on this comment!

      Although I agree with Shannon’s point that obesity is not the major reason for high cost of health care in the US, I disagree that obesity is not a major cause of health issues. All kinds of shapes and weight can be healthy, but only within a certain range. Just as someone who is 5’6″ and 85 lbs cannot be healthy, I also cannot believe that someone of the same height and 200 lbs heavier can be. But I’ll keep reading.

      • February 9, 2012 12:05 pm

        I love skepticism, Linda. Skepticism is what brought me to this point in my understanding. Keep on reading and I hope you find what you’re looking for.


      • February 9, 2012 12:22 pm

        LInda, I am between 5 foot six and five foot seven and I weigh 300 pounds. It really does not affect my ability to do things and nor am I particularly unhealthy. I am within an acceptable health range for my age group. I have one issue which is common to people in my age group: hypertension. This can happen regardless of size, in fact my brother, who is not overweight, was first diagnosed with hypertension IN HIS TEENS. My father, who was also not overweight, had a stroke at 68 due to previously undiagnosed hypertension. I, the Fatty McFatpants, take my antihypertensive medication faithfully. This lowers my risk for stroke.
        I do not know the reason why I am the size that I am, given that I do not eat more than other people, although I have endocrine issues and that probably explains a lot. But size is not an indicator of health. I would have the same health issues that I have regardless of my size. The “obesity diseases” tend to strike more often as a person gets older, and the tendency to have certain problems is more likely based on genetics. Size too is based on genetics more than any other factor.

    • February 9, 2012 12:14 pm

      Joe, guess what? I’m fat, and I’ve only missed three unplanned days of work due to health issues in the past 6 years, and none of them had a thing to do with my size. One time was due to severe menstrual cramps. One time was due to having the Norovirus and having to keep my butt on the toilet with the trash can in front of me. That was a lot of fun. And the third time I had wax pressing against my eardrum and it was causing me vertigo. I have missed no more–and possible less–work than my thinner counterparts. And it isn’t because I’m young. I’m quickly heading into the AARP zone. There are many more like me out there than you can imagine.

      • February 9, 2012 12:20 pm

        I don’t get the whole work argument. I’m fat and I miss a shitload of work. You know why? It’s not because I’m fat, it’s because I have two kids in daycare (aka germ factories) and I get some bug or another every few weeks or so. Most of the time I work through it. This latest one laid out our entire family for two weeks (although I never got it, knock on wood… Lottie and Linny just went back to school for the first time today).

        The studies that look at the economic costs of obesity use highly questionable methodologies. Same with the medical cost estimates, which frequently include psychological costs in the estimates. So, first they get to stigmatize us, then they get to complain that we get psychological treatment for the effects of stigmatization. Bonus!


        • February 9, 2012 12:24 pm

          Exactly! I really don’t know any fat people who miss work due to being fat. It’s a ridiculous argument.

        • Jordan permalink
          February 9, 2012 2:32 pm

          Perhaps you got sick because of your excessive weight?
 (all sources are cited within link)

          Whereas if you were at a healthy weight, perhaps you wouldn’t have missed a “shitload of work.”?

          • February 9, 2012 2:50 pm

            Why are you trying to prove it’s fat that made me sick rather than the well-accepted fact that kids who go to daycare spread their germs like candy? And did you miss the part where my wife and kids were all knocked out for nearly two weeks with a nasty virus and I escaped unscathed?


          • Jordan permalink
            February 9, 2012 3:19 pm

            Oh I agree, kids are germ factories – no doubt about that. I’m not trying to prove anything. Perhaps I wasn’t clear in my response. I’m not suggesting that fat = getting sick.

            “You know why? It’s not because I’m fat” – seems to be completely ignoring that your immune system may not be up to par due to your excessive weight. I really interpreted that comment to say it’s NO WAY due to having a suppressed immune system from excessive weight.

            Also trying to compare yourself to your family getting sick is dubious at best. A one time instance is hard to glean anything from compared to long term.

            • February 9, 2012 3:25 pm

              I would question the studies that show immune system having to do with obesity. Much of the obesity correlations are complicated the the obesity/poverty/education link that leaves many poor people with inadequate healthcare. Are there studies that you know of which have demonstrated a causal link between weight and immune response?


          • February 9, 2012 3:44 pm

            Jordan, my immune system is no different than it was when I was younger and weighed less than I currently do. If anything, I get sick less now than I did when I was younger.

    • Lord of Excess permalink
      February 9, 2012 8:59 pm

      You know what lets talk about something driving the cost of health care … BOOZE. Legal BOOZE. How much does drunk driving and alcoholism cost each year? Why isn’t more done about that? How about anyone who drinks at all, smokes at all, does anything that might drive up costs of healthcare … how about they get publicly bashed continuously. How about society discriminate against those people.

      The “fat people” cost taxpayers money thing only goes so far and it is very easy to take that argument on its own and break it in half by applying it to hundreds of other “lifestyle choices.”

      Bottom line is people love to hate … the anonymity of the internet is a great place for people whose lives are lacking something, to just lash out at others with half-assed, illogical rage and that is what a good percentage of this argument pertains to.

      Civility, respect for others and a focus on human dignity would go a long, long way with this and so many other issues!

      Thanks again for this blog and bringing the other side out on this issue … bravo … more voices of reason need to be heard on this issue.

    • February 10, 2012 9:26 am

      i was told by nurses themselves that the main source of heath expenses actually come from (in no particular order as I’m remembering these) smoking, drinking, and drugs. ie. SUBSTANCE abuse.
      I would also like to mention that I have cost people a LOT of money through the health system and I’m skinny. (I’m not proud of that, just saying that it’s NOT people who are fat who cost the most.)

      • Emerald permalink
        February 10, 2012 1:20 pm

        Fiona, here in the UK, the biggest wodge of health spending is elderly people. We have a lot more of them than ever before, living longer with chronic conditions (and I’d guess the demographics are similar for most of the developed world). But getting old isn’t a ‘lifestyle choice’, and the government hasn’t (yet) convinced people that it’s OK to hate on the elderly. I thought it might be heading that way when some research a while back claimed that being fat could be a ’cause’ of Alzheimer’s – it wouldn’t surprise me if government sources tried to make out that the most devastating disease of old age is fat-related, therefore ‘self-inflicted’, therefore not eligible for care funding.

        (And, yes, unfortunately, we really do have to look at such claims with this in mind now. Since the widespread media attempt in the UK in recent years to convince the public that everyone on long-term disability benefit isn’t really sick and is ‘scrounging’ – undoubtedly to try and popularize a swathe of cuts to such benefits – abuse and violence against disabled people have increased hugely. (Fat hate is tied up in some of that, too; if you’re fat and you have a disability that requires a mobility scooter, it will almost always be assumed that you ‘ate yourself sick’.) This is what actually happens when a society starts to blame sick people for ‘costing taxpayers money’, and personally I don’t think it’s one we should be aiming for if we want to keep calling ourselves civilised.)

        • Jackie permalink
          February 12, 2012 5:20 pm

          In regards to fat people using ECVs, people also will assume you are beimg lazy and should be walking. Or they’ll think you don’t have a right to a scooter a genuine handicapped person might need, if you rent a scooter.

          This is based on my sister and my own experience at Disneyworld. My sister says it’s also common for jerks to jump in front of ECVs to harass the riders, fat or thin. I saw a kid do this, and gave a really mean loom at the father like, “Oh and I know you’d be blaming my sister, because you can’t teach your kid not to jump in front of moving vehicles, if he was hit!”

          Although it seems like it’d be funny, getting up out of the cart and walking up to them will only confirm that you don’t really need an ECV. It’s like ral life internet trolls.

          • February 13, 2012 2:20 am

            I am so sorry that your sister goes through that, people are so cruel. it’s not okay at all. it makes me so MAD to hear that. (((hugs)))

        • February 13, 2012 2:24 am

          I missed out the elderly but you are right, they do need the most health expenditure. But that’s all of us. We are all going to get old. We are all going to get sick eventually, we are all going to die. I hope that elderly hating never happens because what would they then want us to do? it’s one of the reasons that I am wary of voluntary euthanasia even thought I see the good side too – how many elderly people would be pushed into it as their relatives/other people in this world made them feel like a burden? Who has a right to say when you are ‘too old’ and ‘too unwell’ to live?
          Who has a right to say when you are too fat? When you don’t deserve health expenditure? it’s a pool for the reason that we don’t know when we will need it -everyone contributes as they are able. Fat people pay taxes too, why can’t they use what they paid the taxes for ie health? People just hate on those who are easiest to hate sadly.

  3. dusty permalink
    February 9, 2012 11:11 am

    thin does not = healthy. you’re simply creating another stereotype and guilty of the same thing you’re complaining about in the first place but about thin people. healthy = healthy. and there’s no arguing that.

    • February 9, 2012 11:18 am

      I’m not sure if this is directed at my post, but I completely agree that thin does not equal healthy.


    • February 9, 2012 11:19 am

      dusty, I think you misread something. Shannon is saying that SOCIETY claims that thin=healthy and fat=unhealthy. He is saying that society is wrong. 🙂

      • dusty permalink
        February 9, 2012 4:37 pm


        i was in fact directing that comment to your post.


        society does not actually claim anything, society does not have a voice and it’s disingenuous to claim so. and it certainly does not speak for me.

        both thin and fat (if i must use that word) come with health issues.

        what really matters in health is very simple: what do you put in your body? if it does not grow out of the ground, have gills, live in a shell or walk on all fours, you shouldn’t eat it. period. everything else is NOT food. what you put in your body matters to all of us. take some responsibility for your place in our world. walk lightly and leave the smallest footprint possible.

        live your life and be healthy doing it, contribute to your society in an engaging and positive way. and we’ll all be better off.

        be you fat, thin or in between.


    • February 10, 2012 9:28 am

      I’m thin (underweight, bmi 15) and I am NOT healthy. Not by a long shot. Most fat people I know are much, much healthier than me.

  4. February 9, 2012 11:15 am

    I am SO PROUD OF YOU, Shannon – and proud to have my name associated with this cause.

    I have supported this campaign with my money because I was a fat kid who was bullied and shamed by others. No child should EVER have to experience the hours and years of tears and self-hatred that I did. It’s sickening that it’s been sanctioned by a bunch of adults who, ten to one, never went through school being bullied.

    I don’t care who you are – doctor, lawyer, merchant, chief – it is not OK to make fun of someone based on appearance. It’s arrogant and it’s cowardly and the words hurt no matter where they come from.

    Ragen Chastain has a wonderful saying: “No one ever hated themselves to health.” These “Strong4Life” (or as I prefer to call them “Wrong4Life”) folks have made some terrible choices, first by using HEALTHY children to falsely depict children suffering from “obesity,” which is not a disease, by the way. It is a physical condition, but it does not in any way preclude health. These Strong4Life billboards are an outright lie intended to terrorize children and their parents into accepting a societal physical standard as proof of health, which it most emphatically is not. Not only that, they stigmatize vulnerable children, basically sanctioning the bullying they will already experience from peers.

    Fat isn’t necessarily a choice, although society would have you believe it is, and health and weight are not synonymous, although again society would have you believe they are. There are healthy fat people and unhealthy thin people. Weight of all kinds is a complex combination of choices, environment, health, treatment, stress, and genetics. It’s time to stop judging and shaming people for their bodies and start accepting people for who they are. We are not all meant to be the same shape.

    Here are a couple of links to research studies that you might wish to review before you jump onto the Strong4Life bandwagon:

    Fat people are PEOPLE, and we are not here to be taunted, degraded, or otherwise shamed. We are human beings who deserve to be treated with dignity and respect. We are not people “too,” we are “people,” full stop. Stop the fat-bashing; stop the hate.

  5. Tig permalink
    February 9, 2012 11:18 am

    Hi, I hopped over from the BBC site for a nosey. Very, very interesting post. Thanks. Given me a lot to think about.

    • February 9, 2012 11:20 am

      Welcome to Fierce Fatties, Tig. All we ask is that you give it some thought. It isn’t easy shedding popular wisdom, but the research is there and the subject is immensely interesting. If you have any questions, concerns or want to present evidence you believe may contradict our beliefs, please do so at any time.


      • February 9, 2012 11:47 am

        I’m thrilled to see someone do just that – challenge themselves to open up their thoughts. It can be so hard to do because we’re so conditioned to accept “conventional wisdom,” of the “well, everybody KNOWS this is true,” variety. We don’t stop anymore to think, “HOW do we all know it’s true?” or “Just because it might have been true once is it still true today?” or even “I trust the person who says this, but where did they get their information?” So it can be hard even to think of those questions. I’m impressed and thankful that you’re open to new thoughts!

  6. Angie permalink
    February 9, 2012 11:52 am

    You know what happens when people stop eating? They die. And much, much, much faster than any disease correlated with (but not proven to be caused by) obesity.

    This isn’t rocket science. Forget about your weight. Eat good food and move your body. Be kind to yourself and others. Eat the damn cake if that’s what will keep you sane.

    For people who are “healthy,” some folks sure do carry around a lot of anger.

  7. pyctsi permalink
    February 9, 2012 11:54 am

    So tell me, how long am I meant to stop eating for, last time I tried that I passed out after less than a week and almost ruined my metabolism.

    You seriously think if it were that easy there would be a single fat person left?

    If you want to have a discussion then try again, if you just want to be rude and hurl abuse then go away and stop wasting everyone’s time.

  8. February 9, 2012 12:02 pm

    Matt, I think if you were obese you would be able to see the idiocy of your comment. Sadly there are more and more young people taking your advice and starving themselves because they fear the shame, stigma, and hatred that your suggestion to starve oneself illustrates. We are here to stand up to the bigotry and hatred with facts, and justice and a spirit of wanting to help everyone see that like uninformed folks from the not too distance past got very upset when they were informed that the world is actually round. Just because there are more people who will join you in your hatred that will join us in the pursuit of justice and truth doesn’t change the fact that you are wrong.

    Please do not share your “starve myself” comment with young people because some of them will actually do just that.

    • February 9, 2012 12:11 pm

      I did. I also learned to purge when I was 13. I missed this Matt jerk–not much to miss, I’m sure.

    • February 10, 2012 4:40 am

      A lot of young people do starve themselves. A lot of them are anorexic. Some die from it. Some commit suicide because they think they’re fat. More deal with the problems brought on by anorexia and bulimia, including bad teeth, ulcers, colon problems, amennorea (in women), and osteoporosis starting in their 20s.

      Do we really need a campaign designed to increase school bullying? Last I heard, there were many programs trying to cut it down, and recognizing how much damage it does. In some cases, the bullied children are murdered, in other cases they are injured so badly they are hospitalized, in other cases they commit suicide, in more cases they have lifelong psychological issues, and in still more cases they do not live up to their life’s potential. I most cases they avoid school or scouts or wherever they are bullied.

      Let’s just call bullying what it is: It is systematic abuse. It is periodic assault. Why do we want to encourage this behavior? Furthermore, do we want to live in a society where bullying is acceptable?

      • February 10, 2012 10:24 am

        Exactly, Beth. I was bullied mercilessly throughout school. I am now approaching 50 and what was done to me all those years ago still effects me. I attempted suicide several times. I still tend to be rather paranoid and question other people’s motives. I have never had a successful relationship and have always ended up with predatory men and thus always ended up hurt. One of these men sexually assaulted me.
        I tend to second-guess my every idea. I have never succeeded at anything. I feel this is greatly due to having been bullied the way I was. No child deserves to go through what I experienced.

  9. February 9, 2012 12:03 pm

    Ah yes, the semantic argument against obesity. Goodbye automatic asshole.


  10. February 9, 2012 12:09 pm

    Amazing as usual!
    I realized when I was in my early 40’s that yo-yo dieting had contributed to the wreckage of my metabolism. I no longer know if it is even possible for me to lose much weight short of getting cancer or some other such life threatening illness and I’m trying not to care. Believe me it’s hard–it’s so ingrained into my emotional makeup to berate myself for being heavy.
    I mentioned before that I eat LESS now at almost 300 pounds than I did when I weighed 150 pounds. It makes not one damn bit of difference. I’m still fat.
    I’m trying to re-integrate regular exercise. It’s hard for me, not because I dislike exercise but because I equate exercise with attempted weight loss. Therefore, in my psyche, if I don’t lose weight when I exercise, I am a failure. I am trying to reprogram myself to see the gains from exercise such as increased strength, endurance, flexibility, and lung capacity.

  11. February 9, 2012 12:44 pm

    I’m a recent reader to this community, brought here by my lovely friend Pyctsi. In the past few weeks, I have really worked heard to change my conceptions about health and weight and have been trying to find out as much as I can about this movement. My complete and utter contempt for that ad campaign had me reaching for my wallet, and sharing with everyone I could.

    I grew up as a bullied fat kid in Georgia, so I know how much that hurts. I’m still trying to process all of that abuse and I’m still trying to change my thinking. When I tell people I love about this, they think I’m “burying my head in the sand” much like the asshole first poster. For the first time though, I feel like my eyes have been opened. I have been afraid to have health conversations with my husband because they always turned into weight conversations. I’m trying to change his thinking too but that’s proving more difficult as he was never a fat kid, and has had 10 more years of this rhetoric running around in his brain.

    Anyway, I have been reading the facebook and sharing and liking as much as I can, but wanted to say something too. I’ll keep reading and commenting and I am just so grateful that now I have found a community of people where I don’t feel like an outcast.

    So thank you.

    • February 9, 2012 3:47 pm

      Welcome, Jen. I encounter the same “you’re deluded” rhetoric–including from my own mother, who concern-trolled me because since I’m going through menopause it will supposedly make me gain weight, and in her words, “you are already very overweight.” But yet when I come over there, she insists on dragging out every bit of food in the fridge. Go figure.

  12. Catgal permalink
    February 9, 2012 12:50 pm

    What if I told you to just STOP BREATHING? Eating is a very basic need. You can’t just stop. Even if you did your body would do all kinds of things to sabotage your effort. Including slowing metabolism because it thinks it is in famine, which is what you helpfully suggested.

    You say “If I were obese…”, well, you obviously aren’t, so how do you really know what you would do?

    I am tired of hearing the same platitudes over and over by people who don’t want to hear what we are saying and just want us to stop being fat.

    Just stop eating / Obesity is a choice (does anyone really believe that people choose to be in a position that makes them subject to ridicule and hate?) / I did it (lost weight) so anyone can do it (I would like to speak to these people 3, 5, or even 10 years from now and see if they have maintained that weight loss. 95% of people don’t.)

    I could go on and on, but won’t. I will mention that I am also done with the stereotypical assumptions as well. Trust me, not all fat people sit around and eat all day. Guess what? We’re not all lazy either.

    We are members of society no matter if you like it or not. Is it impossible to open your mind and consider the studies and information that have been put forth, or would you rather just hate?

    • February 9, 2012 3:49 pm

      Catgal, I think some want to have a scapegoat and others think that just because their body is a certain way it means everyone’s body could be this way if we “just did” as they say/do. Often these are people from a privileged category (i.e. naturally thin, in a better economic class) and they just don’t understand because they’ve never experienced it.

    • Jackie permalink
      February 12, 2012 5:26 pm

      Catgal, I think the “I did it you can too!” pople are looking for attention for losing weight. Nothing burns them more, than the realization being made by a fat activist that their “success” is due to genetic luck.

      It’s like a gamer bragging about winning a game on the easiest setting, to someone who won the extremely hard setting. These people who manage to lose weight, have a genetic power up that many fat people don’t.

  13. February 9, 2012 1:22 pm

    No, it wasn’t, faycin. He was a troll, pure and simple.

  14. Persona Nongrata permalink
    February 9, 2012 2:00 pm

    All physical health issues aside… Don’t you think these children would be happier if they were more attractive?

    It seems pretty clear that the vast majority of people think that fat is ugly. And you can disagree with that for what good it does you… but it won’t change the way that a fat kid is perceived or treated.

    Letting your kid get fat is like dressing him up in a bikini, top hat and clown shoes every day before school. That kid is going to catch hell for the way he looks and it is in large part the fault of the parents.

    It is just as important to take responsibility for children’s happiness as it is their health. Parents need to acknowledge that they can’t change the world to make life kind to a fat kid… but they can keep the kid from getting fat.

    • Fab@54 permalink
      February 9, 2012 2:05 pm

      Look who’s back…..

    • February 9, 2012 2:07 pm

      I don’t know, your personality is pretty fucking ugly and you seem to be doing okay.


      • Persona Nongrata permalink
        February 9, 2012 7:28 pm

        Wow Shannon… very mature…

        I’m not even sure what I did to deserve a response like that. I was just trying to get people to talk about the psychological side of growing up fat instead of just the health issues.

        I believe that by allowing me to grow up fat my parents were guilty of neglect. They could have done better for me and I would have been healthier and had a better ego as a youth.

        I’ve since lost the weight and kept it off. I’m now a circus performer and I get to travel the world and make a great living. I never could have done that if I were still fat.

        Let me ask you this…

        By letting a child grow up fat you are preventing it from achieving so very many things. The kid will never have a chance at many youthful activities and adult professions that someone who was thinner would have. No hope of being a champion diver or an astronaut or a contortionist or a model or even an airline steward.

        Why not raise a child thin so that it has all of the opportunities in the world open to it? Not to do so seems cruel to me.

        • February 9, 2012 9:25 pm

          LOL Forever! Obviously someone has reading comprehension fail. It’s the STIGMA of being fat that most causes misery and stress in fat kids. If we get rid of the stigma associated with being fat, and the privileges associated with being thin and conventionally attractive, then everyone gets to be happy and respected regardless of their size. See how that works? Noone should be laughed at because of who they are, noone should not get hired or mistreated because of their size. It’s not MY SIZE that’s the problem, it’s people’s CONCEPTION of my size that’s the problem. Thanks for playing!

          • Persona Nongrata permalink
            February 9, 2012 11:18 pm


            Its not the stigma… its the fat.

            Also, some people SHOULD be laughed at because of who they are… CLOWNS… sorry bad joke.

            If you think its not your size that is the problem but peoples conceptions… well that is just selfish.

            You want the whole world to change its mind about fat people instead of changing yourself! Not realistic.

            This whole “fat activism” thing is very American I must say. Still trying to impose who we are on the world instead of changing to meet the future.

        • ChrisPalmer permalink
          February 9, 2012 10:43 pm

          Persona Nongrata – while I agree that talking about the psychological aspects is important you are just getting it all wrong.

          Maybe for you your parents shouldn’t have let you grow up fat; maybe you were one of the people that had a chance not to be fat. The point is that not everyone has that choice. For every child that was bullied as a kid because they were fat when they didn’t “need” to be there were kids that were damaged psychologically because they were fat and tried beyond reasonable measures to not be fat.

          The problem with kids being bullied for being fat is not with the fat kids themselves but with the kids doing the bullying. Smart kids get bullied at school for being smart and nerdy, do you think that we should stop trying to make our kids smart? Not to mention that the societal stigma against fat people doesn’t only affect fat people, it also is a cause of anorexia and bullemia and other eating disorders that afflict think people. If we magically were able to make all the fat people not fat, wouldn’t societies definition of fat just change? Wouldn’t that just lead to us pushing more people to the thinner end of the spectrum and all the health problems that brings with it?

          As for your comments on career choices they are just laughable. Yes fat people won’t have the same career opportunities that thin people have, but thin people don’t have the same opportunites as fat people. A thin person will never be a sumo wrestler or an NFL lineman. Take Vince Wilfork of my beloved New England Patriots. He’s 6’2″ and 325lbs which gives him a BMI of 41 or so – i.e. Obese by BMI. Yet he can run 40 yards in 5.08 seconds and has a vertical leap of over 26 inches. Are you trying to say that he would be better off in his chosen profession and life if he was 190 pounds, which is what it would take for him to have a BMI in the Normal range (24.9).

          Just crazy, absolutely crazy.

          • Persona Nongrata permalink
            February 9, 2012 11:20 pm


            We all have a chance not to be fat. Stop making excuses for peoples behavior. I did it… so can everyone else.

            Sumo wrestlers and NBA linemen die young… fact. All the thin professions I mentioned can live to see 100.

          • February 10, 2012 12:49 am

            Very well said, Chris. This Persona Nongrata is less of a troll than some we’ve had here, but the points they’re making are just as ludicrous. The very idea that I should sit there and allow people to mock me because I happen to not fit one’s social ideal of an “appropriate” body type is asinine.

        • February 10, 2012 11:18 am

          Don’t be coy. You state your opinion on the attractiveness of fat people as though this were an objective fact. We live in a culture that reinforces the belief that thin is attractive and fat is ugly. At the end of the 19th Century, the most famous sex symbol of her time was Lillian Russell, a woman who weighed over 200 pounds and had an infamous appetite. There is no objective proof that fat is ugly and thin is pretty, and your comment was a cheap swipe at fat people. Don’t be an asshole and you can present your opinions, but saying that fat people are ugly as though there is research to back you up is absolutely ridiculous.


    • February 9, 2012 3:09 pm

      I never had the opportunity to be happy because it was burned into my brain that I would NEVER be pretty (and therefore loved and happy) if I didn’t lose weight. I remember being made fun of for being fat the FIRST DAY of Kindergarten and it didn’t stop until…well it never has stopped, has it? My parents were right there, too, giving me diet pills and forcing me to do exercises I loathed when I should have been having FUN and being a KID. My Dad called me Shamoo once when I wore a black and white swimsuit; I was no older than 10. I didn’t wear a swimsuit again without clothes over it until I was 25.

      Unless you know what’s it like to have your ENTIRE life dictated by self-hatred, please SHUT the HELL up and DO NOT REPRODUCE!!!! NO child should have to grow up the way I did and your comment makes it clear that’s EXACTLY what would happen.

      No one “LET” me get fat. I always was fat. I ate the same food my skinny brothers and Dad did, I was MUCH more physically active and yet, I was and am and always fucking will be fat. Even when I starved myself for 3 months I was fat. Even when I was in the hospital for days bleeding from you-know-where because of laxative abuse, I was fat. Even when I spend -hundreds- of dollars to lose 30 pounds in six weeks I was fat. I got fat-TER once I went back to a normal (affordable) diet. Right now, as I sit here, shaking with rage and frustration, I am fat. BUT. Thanks to the FA community, I know now THAT IT OKAY! Fat is not the worst thing a person can be, and I am shouting that to EVERYONE all day every day until I die. Not just to remind myself, but to teach kids that they do not have to feel bad for being who they are.

      • February 9, 2012 3:33 pm

        PS: If the kids at my school hadn’t been taught what you have been taught/are perpetuating, if those kids didn’t grow up being primped and preened and told to be perfect or no one would love them, I might not have been bullied at all. Perhaps if parents taught their kids to be kind to their bodies -and- other people’s I’d be a well-rounded adult. Instead I’m sitting in a dim room behind a computer with social anxiety so bad I can barely function. *thumbs up motion with awkward smirk*

      • Persona Nongrata permalink
        February 9, 2012 7:32 pm

        Hey Sandy

        I do know what it is like.

        Not my whole life. Just the first half. Then I lost the weight. You can too. Don’t give up hope. It was the hardest thing I’ve ever done… but also the best. So many doors opened up to me.

        Better jobs, better relationships, better sex… better living!

        That is why the kids in your school were taught that way of thinking. If you follow through with it… you grow up happier.

        I’m sorry they used it as an excuse to persecute you. That was not fair… but that is kids.

        • Sandy Ferrell permalink
          February 10, 2012 1:03 am

          I’m glad you’re in the 5% of people who lose weight and keep it off. That’s awesome for you. I happen to be in the 95% who lose it, keep it off maybe a year or two, and then gain it back. I know because I’ve done it over and over, healthily and not. So you can take your condescension elsewhere; I HAVE A GREAT LIFE -NOW!!- I don’t need to lose weight to be happy and neither does anyone else. It took me 26 years to figure that out, but now that I have, my job is one I adore, my sex life is better than anyone else I know (just like every other aspect of my 8+ year relationship,) and my friends and family accept me and respect the fact that I no longer subscribe to feeling shitty about myself because people like you tell me I should.

          I won’t be coming back to this thread because it’s bad for my health. My mental health. That oh-so-important bit of health concern trolls like you always seem to forget.

        • February 10, 2012 9:32 am

          It is such a shame that we are not taught as kids to love ourselves as we ARE, that people come in all shapes and sizes and that we, as we ARE, are perfectly okay. A lot of bullying, and waiting to live until we were ‘different’ would be avoided.

    • February 9, 2012 3:52 pm

      Could it be our old buddy Fat Bastard? Just as jerktacular as ever. If not, it’s a clone, and there is no difference. He’s still an asshole.

      • Persona Nongrata permalink
        February 9, 2012 7:34 pm

        Sorry fay

        I’m new here. Can I ask why you think I’m being an a-hole?

        I’m trying to be genuine and compassionate here. I was a victim of fat related abuse for many years and I’ll never forget that.

        I do think that it was wrong for my parents to let that happen though… and for the record, they agree!

        • February 10, 2012 10:35 am

          Well, I will apologize for thinking you were another incarnation of Fat Bastard, a well known and loathed troll. But your assertions that “anyone can lose weight” just because you did assume a lot. Telling people that they are unattractive does not seem very geniune or compassionate in my eyes. You may think you are being so, but you need to attempt to see things through other people’s eyes. You also need to check your prejudices. You have been TAUGHT that all fat people are ugly/lazy/gluttonous. None of these things are necessarily true. The only thing you can tell by looking at a fat person is that they are fat. You cannot tell their state of health, and whether or not they are attractive is only in the perception of the beholder.

    • February 10, 2012 3:41 am

      I disagree PN – Parents CAN actually change the world and make life nice for fat kids by teaching their children THAT BULLYING IS NOT OKAY. If a kid’s life is sucky (be them fat or otherwise) because of bullying that says more about the bullies, their lives, and their environment than it does about the bullied child.

      I was a chubby kid growing up – not fat, but certainly not a slim as my friends. I was rarely bullied. In fact I don’t actually remember a point in my childhood were my weight was made an issue by my peers. My father however, had a lot to say about my weight – and that impacted me right into my (now) adulthood.

      I am now a fat adult to 2 extremely slender children and I teach them that people come in all sizes. Some are fat, some are tiny, and some are scattered throughout the middle. My children are being raised in a household that does not target people for their weaknesses, differences, or handicaps. My children are not bullies and do not make the lives of other children horrible. Children emulate what they see, if they see bullying then they do bullying. Life can be nice for everyone if people raise their children to be decent human beings.

      • Fab@54 permalink
        February 10, 2012 10:58 am

        Sing it Sistah!! ^5

      • Emerald permalink
        February 10, 2012 1:48 pm

        Cheers to you for this, AFP.

        I had a similar situation to yours in that I wasn’t markedly fat as a teenager – I was a UK size 14, which plenty of others in my class also were – and while I suffered some bullying about being a socially awkward geek, I wasn’t bullied at school for my weight. I did, however, have a very thin mother who regarded any woman who wasn’t thin and perfectly turned-out as undisciplined and worthless. It’s taken me until now, after her death, to start unpacking some of the damage she did. I didn’t have children of my own, but I applaud anyone who’s raising kids to value themselves, and other people, for their inherent worth rather than a number on a scale.

    • pyctsi permalink
      February 10, 2012 4:48 am

      I had a chance to grow up not being fat, in fact I did, but since I have broad shoulders I don’t look thin and we all know what you are if you aren’t thin, right?

      I was healthy, fit and active, I was good at some sports and not at others, I enjoyed reading, cycling and roller-skating. I was significantly more active and ate better than a large number of people I knew, I never smoked. However since I wasn’t thin they dubbed me fat. The stress finally got to me as I go older and I was less inclined to exercise – who wants to when you are going to be hassled for it?

      I became fat. This whole thing about fat kids looking better, I was a cute kid (hideous hair cut for a while) I’m still attractive. Being thinner wont make me more attractive, it just means all those guys who judge a woman’s worth by how much they want to sleep with her will get in my face.

      Fat does not equal ugly and I find that people who make that statement are never really interested in how healthy a person is, only that they are ascetically pleasing to them. Which encourages dangerous eating practices and can lead to eating disorders.

      Nobody needs to change how they look to please another person and bullying for any reason is wrong.

      • February 10, 2012 10:39 am

        I had a big butt and thighs once my body started to develop. So the other kids called me fat. In response, I became bulimic. It did not make my butt look any less big in comparison to the rest of me. I destroyed my metabolism by extreme dieting and disordered eating behavior in my teens, twenties, and thirties. I no longer give a flying rat’s ass whether anyone sees me as attractive. If they do not, they can fuck off and leave me alone.
        And absolutely 100% agree with you–bullying for any reason is WRONG!

    • February 10, 2012 9:30 am

      I don’t think fat is ugly. But I really really really really think that mean is ugly.

    • Kala permalink
      February 10, 2012 11:35 am

      This is why what you are saying is garbage. Let me preface this with the fact that I am using attractiveness here to mean physical attractiveness, but was too lazy to write that out over and over.

      One can find oneself attractive, and many liberated fat people and any people in general with healthy confidence do feel that way about themselves. But more commonly, we derive how attractive we feel based on the responses of others. But no one should be deriving their self worth from the opinions of others. It isn’t healthy, and I can’t see one good reason why we should.

      At any point in time at history, various things have been considered unattractive, and some things I think consistently are considered unattractive (scars and large birth marks, as an example). Fat women have been considered amazing in some cultures at some points in time, and disgusting in others. In the USA still to this day, there’s a strong wave that says that African American women aren’t as beautiful as white women, and that goes especially for darker skinned AA women. Colorism as a basis for attractiveness is pretty rampant across the world, especially in Asia. Should we say to dark skinned children, that are considered ugly in their community, that they should lighten their skin to feel pretty?

      When we as a society say, let these children derive happiness from their thinness, and thus attractiveness, what does that say to children who will never be considered conventionally attractive? People with less than symmetrical facial features, people with disabilities that affect their appearance, people whose appearances have been marred by disease or injury. It tells them that they aren’t worth as much as the rest of us, and that’s just a crock of shit.

  15. Jordan permalink
    February 9, 2012 2:11 pm

    Shannon – you point out in your article that the fat isn’t to blame for health issues:

    “…Why? Is it because I have five less pounds of fat cells on my body?
    “…This question stems from a weight-based metric of health. In this model, fat is the disease-causing agent and losing fat is the cure. But the propensity of research does not support this model…”

    These two statements are factually false. You can’t simply ignore the fact that the human body is a complex biochemical system. Adding 100 lbs of adipose tissue to this system will cause a myriad of negatively cascading effects throughout the entire system as a whole. Visceral fat is a strong hormone signaler by itself!

    Do you think anyone would give fat a second glance if it DIDN’T cause health issues?
    There are mountains of studies proving that FAT causes health problems.

    Now HOW that fat comes to exist is a different issue, even if those pathways are related to general health on some levels.

    The problem in all of this is that there is a gross societal misunderstanding of what it means to “lose fat”. This is where I’m happy to see your group trying to educate that losing fat is a complete lifestyle change. Not some simple 3-6-12 week crash diet. Fat is a symptom of an unhealthy lifestyle.

    Remember the 3 requirements to sustain life? Food, Water, and Shelter. Food – what you eat – your diet – is a cornerstone of your lifestyle. One cannot have a lifestyle without life. One cannot have life without food (see requirements to sustain life). Your diet is comprised of the food you choose to take in.

    That said – I’m sad to see your group celebrating the status of being fat. Morbid obesity is a situation in which the fat maintained or accumulating on your body is killing you over time.

    Celebrating being fat is akin to celebrating chain-smoking or celebrating cancer. There is nothing to celebrate about being “Fatties”. Enabling people to be fat is not going to solve the health problems that fat does cause.

    In fact, look at what cancer patients did in recent past. Years ago, upon diagnosis of cancer, patients would routinely just give up on life. “Might as well just make the most of it until I die…” Enter Livestrong. They don’t celebrate each other having cancer. They aren’t OK and happy with it when they are diagnosed. They banned together to fight Cancer… to turn a morbid disease into an opportunity to really take charge of their lives, take charge of their decisions on how to live, and fight for it by living healthy. By living strong.

    • February 9, 2012 2:30 pm

      I don’t have time for a full rebuttal, but I would like to ask a few questions.

      First, do you agree that there are different types of fat, namely visceral and subcutaneous? And that subcutaneous fat (aka brown fat) is widely seen as beneficial, due to its fuel-burning properties? Do you agree that studies have shown that people with predominantly more subcutaneous fat are significantly less susceptible to the metabolic disorders which are correlated with visceral fat? And, finally (for now), do you agree that there are ethnic differences in the effects of fat on any given body? In other words, the definition of “obese” (as defined by the negative health effects of a given range, in traditional western medicine this being a BMI over 30) is different from Asians, which is different from Europeans, which is difference from Africans?

      You can probably see where I’m going with this… fat itself is a complicated organ and while the ONLY disease for which causation has been shown (sleep apnea), many others are correlated. This correlation (IMO) is more related to IR than the accumulation of fat, and I can point to studies that show IR, regardless of weight, is a better predictor of disease risk (as is cardiorespiratory health, but that’s another story).

      Anyway, thanks for commenting.


      • Jordan permalink
        February 9, 2012 2:47 pm

        I will be respectful of your time and keep this short.

        Yes – there are different types of fat. Yes – different ethnicities have variations in their biochemical makeup that will affect how excessive fat is handled by their bodies. Yes – fat is a VERY complicated organ! To add 100lbs of fat onto a body that’s 175 lbs will have severe repercussions to all systems of the body. Not just Metabolic and Respiratory.

        What stops your opinion from considering Fat Accumulation could cause / be a cause for IR?

        Finally I eagerly await for a full response to my original post. If you would rather not have it be a public response, please feel free to email me.

        P.S. I would do backflips if the scientific community would stop using BMI and stick to BF%.

        • February 9, 2012 3:01 pm

          I love public responses, Jordan, this is how we hash through disagreements.

          Okay, so you’re citing a 275 pound person as your example of severe repercussions, but is that the average fat person? Well, morbid obesity accounts for 5.7% of the population, while those with a BMI over 50 (aka Biggest Loser contestant-sized people) comprise just 0.42% of the population (I’m using BMI since the studies we’re citing use BMI as a reference point). Now, I’m in the morbidly obese category, but I do not experience any of the biomechanical effects of severe obesity. I’m fully active, I do cardio twice a week and strength training twice a week. Those studies that point to the biomechanical effects of obesity often do not take activity level into account, so, yes, if you are severely obese and sedentary, then what time you spend on your joints is going to be hard on them. But there is research (I can dig it up later) that suggests that being active strengthens joints, regardless of weight. So, as always, sedentary lifestyle is what I see as the boogeyman in this equation. So, I have a problem with centering public health campaigns on a small percentage of the population when ALL people can benefit from the same public health message: eat healthy foods and exercise.

          As far as IR is concerned, I do think that fat accumulation is cyclical, and that excess fat can both cause and be be caused by IR. So, what to do about it? Weight loss is out of the question because of the overwhelming failure rate. What we’re suggesting is do the things you would otherwise do to lose weight (aside from caloric restriction), and don’t worry about your weight. The reason? Building muscle improves IR, and improving one’s lifestyle choices can have a positive effect on metabolic health regardless of weight loss. I just happen to have a whole host of studies that I provided to Strong4Life on this subject, to no avail.

          And these are just the adolescent studies I found. You can find more on improving metabolic health without weight loss on adults all over the place.

          And rather than expecting a huge response, I prefer these smaller back-and-forths. Easier to manage. Be sure to start a new comment so we don’t start noodling threads.


    • ChrisPalmer permalink
      February 9, 2012 10:58 pm

      Jordan – Your analogy to cancer and Livestrong is misguided. Yes people used to give up when diagnosed with cancer and as someone who’s family is dealing with cancer right now I am glad that has changed. However, below is the first paragraph of Livestrong’s manifesto with a few edits of my own (two words changed and two words added)

      We believe in life.
      Your life.
      We believe in living every minute of it with every ounce of your being.
      And that you must not let fat take control of it.
      We believe in energy: channeled and fierce.
      We believe in focus: getting smart and living strong.
      Unity is strength. Knowledge is power. Attitude is everything.
      This is Fierce Freethinking Fatties.

      Livestrong does not say “oh you have cancer? you should not do that because it is killing you.” They say go out and find every piece of information you can about it, get what treatment you can, and failing all else make sure you live the rest of your life to your best ability. How is that any different to what Shannon et. al. are doing right here?

    • February 10, 2012 9:35 am

      You can’t tell just by looking at someone what their body composition is. A ‘fat’ footballer might be a heck of a lot healthier than a skinny model (in fact, he most likely is) but to YOU, he is fat and therefore he must be very very very unhealthy? This is where bmi fails us.
      You simply canNOT tell someone’s health from the outside. Some people are made to be fat. Some people are made to be thin. there is nothing bad about simply being the way your body was meant to be.
      It’s also much more UNhealthy to spend a lifetime of dieting and going up and down and up and down.

  16. Jordan permalink
    February 9, 2012 3:49 pm

    Starting a new Reply per your request.

    To quote:
    “So, I have a problem with centering public health campaigns on a small percentage of the population when ALL people can benefit from the same public health message: eat healthy foods and exercise.”

    According to your sources the obesity rate is 5.7%. What do you think of the childhood obesity rate of 17% that the CDC has posted? After all Childhood Obesity is what the public health campaign in Georgia is targeting…

    Further I’d like to hear a response from you on the following:

    “Weight loss is out of the question because of the overwhelming failure rate. ”
    My knee-jerk reaction to reading this was not good. Please elaborate on what you mean here so I don’t respond to an interpretation you didn’t mean.

    I totally agree that sedentary lifestyles are one of the top contributing factors to poor health, including obesity, by no means am I ignoring diet though. Once again… this is an all encompassing lifestyle change that is needed. Poor lifestyles lead to poor healthy, one of the easiest recognizable symptoms of which – is fat.

    I honestly don’t mean any offense by this next comment, but I can’t think of another way to say it. It seems as though your points against losing weight to improve health are all centered around aspects of scientific research that we, as humans, are far, far from being completing and understanding fully.

    • February 9, 2012 4:22 pm

      I’ve read that post. Here’s my take: NHANES is the most accurate because it actually weighs and measures people. BRFSS and YRBS are phone surveys and their results routinely come in lower than NHANES, so no matter what these studies report, they’re actually an underestimation. Any increases in obesity on phone surveys can be the result of shifting attitudes, not necessarily shifting weights.

      As far as childhood obesity rates, this is where it gets sticky. In 2007, the CDC changed the definitions of obesity for children, just like they did in 1998 for adults. Previously, it looked like this:

      85th percentile to 95th percentile = At risk for overweight
      Over 95th percentile = Overweight
      And, I believe they said over 97th was obese, but don’t quote me on that.

      Now, it’s:
      85th to 95th = Overweight
      Over 95th = Obese

      So, is the increase in rates (the tripling, they mention) due to actual increases in weight, which NHANES says has not changed in a decade, or is it due to the semantic shift that instantly turned at risk kids overweight and overweight kids obese? Good luck finding a clear answer to that from the CDC.

      But here’s the best bit of evidence I have that weight-based metrics are foolish. Healthwise creates content for healthcare professionals and their guidelines are used throughout the medical industry. I stumbled across this guidelines called “Screening for Weight Problems” used by Seton Healthcare. I’m pointing out affiliations because I don’t want you to mistake what I’m about to post for some rinky dink opinion I scraped up somewhere. This is legitimate medical screening procedures used by real clinics. And here’s what it says about a child’s BMI or weight:

      If your child’s BMI has been high on the growth chart from birth, this may be his or her healthy size and growth rate. He or she may simply be bigger than other children of the same gender and age.
      If your child’s BMI pattern has suddenly jumped from a lower range to a higher range on the growth chart, your child may be at risk of becoming overweight. Your doctor will carefully track growth over time, watching for a change in the rate of weight gain. Your child may need counseling and other help to make lifestyle changes for a healthier weight.

      So, major healthcare organizations are using the growth trajectory, not simply BMI, to determine if a child has a “weight problem.” I read this approach in Ellyn Satter’s book “Your Child’s Weight: Helping Without Harming,” which explains the trajectory model in great detail. This is valid. This is a well-thought out approach to weight. By looking at a child’s growth pattern, rather than his or her weight, you can avoid stigmatizing kids who are naturally larger. This is an approach I whole-heartedly endorse.

      Your response to the 95% statistics is warranted. It’s a pretty shocking stat, and one that is primarily based on the work of Stunkard’s starvation studies. Few studies have actually looked at long-term weight loss (5 years or greater), so it’s a hotly debated subject. Most people say that the failure rate is due to fad diets, but I found this great study on the EatRight program in Alabama (you can read my commentary on it here), which is one of those “healthy lifestyle” classes, and after two years the average weight lost was around 5%.

      But as I said in the post above, that 5-10% statistic is ubiquitous in research. You can’t swing a dead cat in weight loss research without hitting it. Hell, read these two studies of Jenny Craig’s effectiveness and you’ll see them explain away the modest results by citing the 5-10% number. Time and time again, if you read a lot of weight loss research, you will see that the people who are “successful” are those that maintain that 5-10% loss, while the vast majority (at least 75%, but frequently more) will regain the weight. From what I’ve read, it works like this: whatever program or dietary approach (low-carb vs. low-fat) there is an initial weight loss phase where you lose the most amount of weight, which lasts anywhere between 6 months and 1 year. After that, the gradual regain and failure. The main reason (IMO) for these backslides is partially because weight loss gurus prime people to expect a 25% or greater weight loss (that’s the average Jenny Craig customer’s “ideal” weight loss), then when they only see 5-10% they say “Fuck it” and give up. Now, if they maintained whatever healthy lifestyle choices they made, this would be awesome and they would be doing themselves a favor, but the fucked up goals that people set for themselves sabotage them every time.

      But as I said in a previous comment, these health improvements come with lifestyle change regardless of the amount of weight you lose. If you’re exercising and building muscle, then you’re trading muscle for fat. But if you’re relying on the scale to motivate you, then you will be disappointed.

      So, that’s my take, there’s tons of research out there, you just have to dig it up.


    • February 10, 2012 9:38 am

      I have a very very poor lifestyle. I will not pretend I don’t. I am very very unhealthy. I am also very very thin. But because I’m thin, does that mean i get off free from my unhealthy lifestyle ? I have fat friends who put me to shame because they eat so well, they exercise. I think my friends and i totally blow the stereotypes out of the water. People just like to pick on those who stand out because they don’t look the way they would like people to look.

      • pyctsi permalink
        February 10, 2012 10:08 am

        Thanks for joining the conversation Fiona.

      • February 10, 2012 10:27 am

        Excellent observations, Fiona. I think you sound like a very sharp young lady. 🙂

        • February 11, 2012 1:58 am

          Thanks, there is a heck of a lot going on here so I’m struggling to keep up (another downside of not having enough weight – I think I have lost braincells too.. okay seriously, I have cognitive problems. Being skinny is not all it’s cracked up to be.)
          I have friends who I hate seeing them suffer cruelty, and I just hate cruelty to anyone. It makes me SO MAD seeing all the hatred to people out there just because they don’t match up to someone’s idea of what they should look like. And so many stupid fallacies. For myself, I’ve been told that because i have anorexia and bulimia, that means I’m manipulative, attention seeking, a spoilt brat. Also I am white, middle class, definitely female..
          WRONG. Same with stereotypes about people who are fat.
          I get mad about kids being taught young that they need to be ashamed of their bodies if they aren’t skinny. I remember as a little kid, looking round and accepting my playmates whatever their size. If they were fun to play with that is what counted. But I was also bullied horribly and that has stayed with me.
          We adults have a chance to bring our kids up with a better attitude to weight and to one another… and we are so close to screwing it up and making it worse 😦

  17. Snowdecahedron permalink
    February 9, 2012 4:18 pm

    I don’t think anyone is seriously suggesting “stop eating”. For sure, any discussion like this will attract trolls. However, remember that not everyone who disagrees with you is automatically a troll.

    My question: does anyone here disagree with the assertion that if you expend ever so slightly more energy than you absorb from food/drink, then over time you will lose weight?

    If you disagree with that position, I’d love to understand your reasoning.

    Full disclosure: I’m probably 30lb over my ideal weight. I eat more or less what I want, drink slightly yoo much and exercise regularly/moderately. My weight is stable. I have a high metabolism due to large muscle mass, so this precarious balance is probably easier for me to achieve than some people.

    However, unless anyone can explain why the assertion above (energy in vs. energy out) is incorrect, I’m left wondering whether some people are just unable to take responsibility for their own food intake. Certainly I struggle with self-regulation from time to time. Luckily for me my body doesn’t punish me too badly (yet) – as I said, I’m blessed with high metabolism.

    Carrying much more fat than is necessary for healthy survival will shorten your life. Do I need citations for that? I hope not.

    I don’t think it’s a great idea to celebrate morbid obesity, but I do commend any effort to educate people so they can lead healthier lives and/or be nicer to each other.

    Me? I’m occupying the middle ground between the “it’s absolutely fine to be morbidly obese” position adopted by some people here and the bullies (who usually have their own self-esteem issues) who make overweight people’s lives hell. I don’t think either position improves people’s lives.

    • February 9, 2012 4:39 pm

      The question that is left open, though, is how much fat is “more than necessary”? Those in the overweight BMI category live longer on average than those in the “normal” BMI category: there are 26,000 fewer deaths among overweight people. Obesity is trickier, but I’ll just agree with you now to make things simpler and address your other question, why does calories in/calories out not work?

      I’m working on a graphic to illustrate this because while calories in/calories out does explain how caloric deficits or excess can lead to weight gain, it isn’t the whole story. It’s more like Calories In >> LEPTIN/GHRELIN >> Calories Out. Leptin and Ghrelin are hormones that regulate our appetite, hunger and metabolism (among other things) and in order to maintain homeostasis (one of the primary goals of all of your body’s functioning) the body compensates for caloric excess or deficit. If you eat too much, your body will rev up your metabolism to burn more energy. If you eat too little or exercise too much, then your body will slow down your metabolism, causing lethargy and sleepiness.

      Honestly, I find this system utterly fascinating because of its complexity. If you want to learn more I have three resources, depending on your level of interest.

      First, there’s this research study if you’re the nerdy math type. Second, there’s this fascinating article on Dr. Jeffrey Friedman, the man who discovered leptin in 1994 (yeah, we’ve only known about hormonal regulation of weight for about 20 years, which is why people aren’t really aware of it). And finally, you can listen to this series of lectures, which includes Friedman himself discussing why everything we think we know about weight regulation is wrong. The others talk about genetic influence on fat and muscle distribution and are equally fascinating, but the “Deconstructing Obesity” lecture is amazing.

      So, basically, it’s really complicated and your body will fight your attempts to lose, or gain, weight, and there are decades of studies to substantiate this claim. If you have any further questions, feel free to ask.


    • pyctsi permalink
      February 9, 2012 6:29 pm

      I have actually had people tell me I should just stop eating, on forums and to my face – they never actually tell me how long I should do it for.

      Thank you for taking the time to be polite and actually asking well thought out questions.

    • Mulberry permalink
      February 9, 2012 10:00 pm

      Snowdecahedron – what a lovely name! It would go nicely with an ice-osceles triangle.

      You ask, “My question: does anyone here disagree with the assertion that if you expend ever so slightly more energy than you absorb from food/drink, then over time you will lose weight?”

      I would have to disagree not with the statement itself, but some of the assumptions implicit in it. It is assuming, for example, that the body in some sense does not care what weight it is. It ignores the whole system of checks and balances in the body; the adjustments the body makes to assure that you don’t stray too far from whatever weight you naturally maintain.

      It’s not “taking responsibility for one’s food intake” that’s the problem; it’s that we can’t dictate what the body is going to do with that food once it’s swallowed. My body usually works to maintain some particular weight or weight range, the same as it works to maintain a particular temperature, or encourages me to get a certain amount of sleep at night. If I feel best with (say) 9 hours of sleep and you are at your peak with 7.5 hours, would you be an ol’ meanie and begrudge me that extra hour and a half? What if somebody did a study that said people who slept 7.5 hours a night lived (on average) the longest?

    • MrsS permalink
      February 10, 2012 7:46 am

      Snow, the eat less-move more theory is almost a fallacy. I say “almost” because there are people for whom it has worked, but for a vast amount of people, it hasn’t. Losing weight and keeping it off is just not that simple. There’s a website named Weight Maven, where Beth, the blogger, provides a lot of scientific evidence on the biological reasons that people may be overweight. While Beth is sympathetic to HAES, she is not a complete supporter, as she herself is trying to lose weight. If you go to her post (enter Weight Maven in Google), you’ll learn a lot about the body and weight beyond the old eat less-move more philosophy.

      BTW, I fall within the normal BMI range, so my answer isn’t from defensiveness.

  18. Dave permalink
    February 9, 2012 4:58 pm

    One quick question, I don’t know as much about the science of fat gain/loss, but I think I understand the basics.

    I am wondering what you would say that weight loss would occur for an overweight person if the quality of the food they ate changed.

    Is it true that an overweight person would stay at the same weight if they still ate roughly the same amount of food, but chose to not eat anything with processed sugar, white flour, etc.

    So if a person’s diet became something like oatmeal/veggies for carbs, eggs, chicken etc. for protein, and nuts for fat, would they stay overweight or would you see weight loss even though the volume of food stays the same?

    Hope my question makes sense.

    • February 9, 2012 6:02 pm

      Great question. I just wish I had a great answer to go with it. 🙂

      The weight changes (or lack thereof) you refer to fall under a theory called Set Point, or a similar theory known as Settling Point. Set says that your weight is predetermined and that once you mature, you reach that set point and stay generally in that range. You can temporarily increase or decrease it depending on your caloric balance, but it generally hovers around 20 pounds within that set point. Settling point us similar, except that set point can shift over time with age or metabolic changes. So you can have a settling point of 150 pounds at the age of 20 and at 30 it may creep up to 160. Both theories have strong arguments, but I currently lean more toward settling point with the stipulation that it moves up, but not down over time.

      I mention these theories because they’re the best known explanations for why diets fail. Whichever theory you subscribe to, the premise is that your weight is like a rubber band attached to a point and the more you pull on it, the greater the resistance you’ll feel from your body.

      So, how does switching from an energy-dense, highly-processed diet to a low energy density diet (veggies, fruits, lean meats, plant-based protein) affect one’s set or settling point? I think it depends on why you’re fat. If your current weight is due to insulin resistance, then eliminating carbs may cause some weight loss, but if your weight is independent of insulin resistance, then you may see less. But I still use the 5-10% figure as a guideline for what the average person is capable of.

      The reason we don’t know more about the exact ways and reasons that certain diets affect our weight is that unlike the heart rate monitors that can relatively accurately monitor energy expenditure, caloric intake monitoring still relies in self-reporting, which is significantly less reliable.

      But compare the traditional weight-based approach to HAES and you’ll see the advantage. From the traditional viewpoint, changing your diet is assumed to cause weight loss, but if it doesn’t then the person is assumed to have cheated or failed in some way, regardless of whether the changes improve blood pressure, sugars or lipids. Without physical period of adherence, the weight loser will not appreciate those subtler changes and abandon then for tastier food and the same waistline.

      Meanwhile, HAES says make those changes and if you lose weight, great. If not, who cares because we’re looking at the lab work, not the scale.

      So, in short, nobody knows with absolute certainty if going from high to low energy dense foods will result in significant (greater than 10%) weight loss. What we do know is that if you make those changes, you will be healthier. Sorry I can’t be more of a help. And sorry for any typos, I’m on my phone now.


  19. Tom permalink
    February 9, 2012 5:41 pm

    I am one of the BBC readers who wanted to know more.

    I love your enthusiasm, your sense of humor, and your openness to the opinions of others.

    But I can’t completely agree with your point of view. From everything I’ve read and learned, I can’t help but believe that being overweight is simply not ideal. Yes, other things like smoking, a sedentary lifestyle, etc, may be worse — but that doesn’t mitigate the fact that obesity can in no way have a positive effect on your overall health.

    Finding the cause (behavioral, endocrine, ???) is important. Attempting to change (via diet, exercise, ???) is important. And keeping your self-esteem intact along the way is important too.

    But I think it’s counterproductive to deny the association between health and excess body fat. And it’s equally counterproductive to claim that as long as you’re happy, it doesn’t matter. I think I’m sorta happy, but that doesn’t change the fact that some of my behaviors are destructive and require some introspection, reevaluation, and change.


    P.S. I’m a nerd and a Start Trek fan. But I hated Enterprise. The episode that broke the camel’s back was the one where they bumped into a ship of young ‘renegade’ Vulcans who wanted to embrace their emotions . One of them was fat. It just struck me ludicrous. Ridiculous. A society based strictly on logic (and theoretically with enough medical experience to solve endocrine issues) just wouldn’t have overweight citizens. I guess I can’t help but feel, aside from medical issues — which the Atlanta campaign certainly isn’t arguing against — even in our society, it seems a little too illogical to deny that obese isn’t the best way to be. Does that make sense…?

    • Len permalink
      February 12, 2012 5:39 pm


      I know you probably didn’t intend this – but I found your post here impressively offensive. You acknowledge that self esteem is important then refer to a fat character in an SF show as ‘ludicrous and ridiculous’? Your comment offended me personally and reeked unpleasantly of eugenics.

      I am a Trek fan as well. Personally I feel the idea of a society where the basic fashion garment never changes for many generations is a bit wacky – but I also appreciate that it is a fantasy, a form of entertainment that at most can invite us to think further. So far so fab. Are you saying it would never cross your mind that a logical, experienced society might acknowledge that fat is normal for some people? Or that physical appearance is not always linked with health? Your viewpoint of a society in which all citizens are homogenous in build disturbs me from a sociological viewpoint. It also disturbs me that you assume some mystical state of perfect health can or should exist in a society. You assume no Vulcans ever get sick? Or just that they would never allow a form of sickness that disagrees with the social standards of ‘visible health’? If an ep showed a Vulcan with a visible disability or illness, what would your reaction be?

      If that episode broke your camel’s back, then human society must be so disappointing for you.

      While health is a lovely thing to have, it is not something over which we – or society – have complete control. Yes, fat people are sometimes unhealthy. Thin people are sometimes unhealthy. Is this a reason to fail to celebrate these people and their accomplishments? Do you really think we ought to live our lives saying ‘Yes I have a great life and a lovely family/friends and I like what I see in the mirror – but UH OH. Better not get too happy because after all, I am not perfectly healthy in the manner enforced by the ideals of society’s most privileged members. Bummer.’

      If you choose to read on you will observe that many members of FFF enjoy discussing their healthy lifestyle choices – exercising, eating a varied and nutrituous diet to the best of their ability – while acknowledging that not everybody has the same privileges, or insisting that health is anything other than a personal state of affairs over which an individual only has limited choices.

      I hope you can enjoy reading and learning and evaluating and being introspective – and indeed commenting – but I beg you, please be aware that we are people, we are individuals and we are not from some utopian civilisation wherein there is no illness and everybody looks the same.

      I am currently a healthy fatty, as it happens. My metabolic health measures are currently ideal, I know that because I had my regular full checkup just recently. So no, I will not spend my time failing to enjoy or appreciate my life because there is a chance that I might not have been as lucky as I am. And if – WHEN – my health fails me, as it will for all of us eventually, I will not spend my time feverishly berating myself for being sick and somehow letting society down. I will take whatever measures are available to me to ameliorate my illness and I will get on with my life to the best of my ability.

      And yes, I appreciate that my fatness may make me more prone to certain illnesses. Within my means I do my best to avoid that – I watch what I eat, I exercise and I get regular heath checkups. If I wasn’t as privileged as I am, I couldn’t do that. Your blithe statement of what you assume is ‘productive’ or ‘counterproductive’ changes absolutely none of that.

      Len (living long and, dammit, prospering)

  20. Liz permalink
    February 9, 2012 5:59 pm

    Hi Shannon !
    I also jumped over the BBC site, and I am glad I´ve found you Fierce, Freethinking Fatties.
    I´ve always thought of the idea that fat poeple have no such health problems as most people think. I do think fat people have something extra that makes them special, that extra it´s life to me, they´ve got the spark and it´s as if they glow. I find them usually funny and witty, if you know what I mean.

    See, I´m from a country where you have mostly the opposite problem: thin people = lots of anorexia and bulimia issues. I find most of the people specially women to be obsessed with having a thin figure. In my opinion, this is a big issue and one that very few talk about.
    I´m glad to say I never feel guilty after eating, but most of the people here feel that way
    unfortunately, and they even “shout it out loud” sometimes as if doing so they were washing their “sins” away..
    I enjoy a lot eating and It´s ironic cause I´m the one who sees this “thin= healthy” people as unhealthy. At least their minds are..

    I didn´t like this Georgia campaign at all Shannon, I just found it horrible but that´s how I found you luckily! I hope you don´t mind my english, and that you´ll get my idea 🙂
    keep up the spirit!
    all the best

  21. Matthew permalink
    February 9, 2012 6:54 pm

    I’m curious about the national and regional nature of the obesity problem in America. It’s documented that there are much higher obesity rates in certain parts of the country than others, and likewise Americans in general have higher obesity rates than most countries in the world.

    I think when people want to campaign against obesity, it’s that that they have in mind: namely, that there’s a socio-cultural dimension to obesity when it occurs at high rates within a community which needs to be addressed. For example, I live in South Korea now, where you see very very few obese people, however you proportionally see alot more obese young adults than adults and obese children than young adults. For anyone familiar with Korea, they’ll know that the country has had an enormous culture change since the 1950s. Sixty years ago, it was one of the poorest countries in the world; today it’s one of the world’s most dynamic economies. Not surprisingly, that’s brought with it an enormous cultural change in the daily living habits of people. While South Koreans are in general much healthier than in the past (compare South Koreans with North Koreans), there is a perception that rising obesity rates are a negative consequence of the material changes of life, and part of the issue is cultural.

    I’m curious whether you think there’s any validity to it, and if not why do we see obesity so much more prevalent in Mississippi than Colorado?

  22. Lord of Excess permalink
    February 9, 2012 8:45 pm

    I was an ultra-fit guy in my early 20s. I played small college football, ran five miles a day, lifted wights 3 hours a day and ate like a horse. After college … marriage … kids … 10 years of sitting on my but in a cube farm trying to make a living … I’m 280 lbs. Back in the day I was 250 and 10-13% bodyfat … now I wouldn’t even want to guess. My mass has shifted from being in my arms chest and quads to being in my gut. I’m a fat guy. I’m a good dad, a good friend, I vote, I pay my taxes, I have a masters degree and am a working professional. So for the record I’ve seen both sides of this debate.

    I think that the issue is complex and I really applaud what your doing on this issue. I think that everyone agrees that allowing childhood obesity to continue unchecked is terrible. Something has to be done. At the same time “fat-isim” is one of the few remaining tolerated forms of discrimination. Statistically obese people earn less, they are turned down for jobs only on the basis of their appearance, etc. etc. that is what your getting at here. The way people are treated, preserving human dignity, allowing individuals to be able to keep their heads up and hopes up. Rather than making feel people ashamed … seriously … all of us who are over weight, obese, morbidly obese … we know it! You don’t need to brow beat us. There are endless, creative, positive ways that just as much media attention, hell even shock value, could have been garnered that wouldn’t have just been another “fat-bash.”

    I guess it just comes down to people loving to hate other people, loving to feel superior, loving to laugh at others … as a way to not feel inadequate themselves. Thin people are stupid, short, ugly, bad drivers, bad fathers, mothers, husbands, wives, employees, golfers, students … they are losers in their own individual way just like many obese people are. Why does someone’s size enter into how good of a human being they are any more than whether or not they like blue, smoke, enjoy rap music, sleep on the job, doodle … it is simply a random thing about them.

    Being fat doesn’t mean someone is automatically lazy, uneducated/ignorant … anymore than being short or liking walks on the beach is an indicator of those things. Those are random stereotypes though that are reinforced.

    The reality is just as big tobacco was responsible for addicting hundreds of millions of people to their products … big corporate food … has addicted hundreds of millions of people to big macs, pizza, ice cream, and all this franken-food that makes it easier to get fat than it ever has been. You couple that with the reality of modern urban life, life in rabbit hutch apartments with lack of open space and recreational facilities, most of us working in dark cubicle farms all day, then going home to sit in front of the TV or PC for hours and hours. The franken-food combined with the very sedentary lifestyle most of us engage in … is automatically going to make a huge percentage of us overweight. Is it our fault? Sure, undeniably. So what is the answer.

    Yes awareness, yes we all need to educate ourselves, get off our butts and work out, eat more fresh vegetables and fruit and less processed crap and meat. I’ve been doing that for a few years now but I’m still obese … slow progress … but I’m getting there. It is my choice though on my time and I’m doing the right things. So why should I be made to feel inferior? Why should people look down upon me? Is that fair? Is that a violation of my human rights? In some way yes it is.

    I’m 280 pounds and pretty proportional I have a barrel chest and big pretty solid arms. My mobility isn’t restricted and I shop in the regular stores for clothes. Yet I have had people yell out their window “your fat” I’ve been given dirty looks, I have been discriminated against many times over the past 8 or so years that I’ve been a “big guy” (a term that I hear nearly every day and try not to visibly cringe at). I’m thick skinned about it all though really, this comment on this blog is a rarity for me. I usually don’t say anything about this issue and just keep my head down on it. But this struck a chord with me I guess. I know that if I’ve experienced this, a normal working professional white guy who is somewhat distinguished looking and probably still intimidating looking … if I get bashed … if I feel a little uneasy about this … well how is a vulnerable teen going to feel? When I was a teen I was a basket-case as we all were … raging hormones … a pimple on a date night … sweaty palms at asking girls out … had I had to deal with being obese on top of all that well I don’t know what I would have done. That I think is the issue here … do we want to drive kids over the edge? To suicide? Anorexia/bulimia and/or to other disorders?

    There has to be a better, more sane way to approach this that allows for some human dignity and values people as individuals.

    • Len permalink
      February 12, 2012 5:57 pm

      I’m happy for your kids, sounds like they’re getting a sensibe, well-balanced upbringing from their Dad. I got teased as a kid too but my parents were like you, very accepting of human diversity – and it helped me to keep my self-esteem intact. I really think that helped me no end and I hope your kids enjoy having such a great, comforting influence as they grow up too.

  23. ChrisPalmer permalink
    February 9, 2012 10:24 pm

    As another BBC reader, I’ll admit that reading the BBC article I initially thought “but surely there should be a stigma against childhood obesity” and what can this Fierce Freethinking Fatties be all about?

    I too read the original post and most of the comments and started to question my thinking. I only wish I had the time to read more (or any) of the studies to learn more. I also rarely comment on articles I find because they too often just end up in flame wars, but the majority of the people commenting here either pissed me off with their ridiculousness or impressed me with their thoughtful opinions (some of which I will reply to directly).

    Here are my thoughts on the subject. I accept that people can be healthy and beautiful in a large and wide variety of sizes (and maybe more importantly worthy or our respect and love) However just because some people naturally carry more fat than others doesn’t make it okay for anyone to do so. My concern is parents/kids who think “well some people are fat and still healthy so it’s okay for my kid/me to be fat”. I think there is a serious lack of education of kids about what it means to be healthy (which is not surprising if we don’t really understand what it means to be healthy). This is what scares me about the “obesity epidemic”.

    I like the premise of HAES, and if you are eating well and exercising well then it doesn’t matter what size you are.

  24. vesta44 permalink
    February 10, 2012 1:10 am

    Holy cow, I missed a lot! Welcome to those who came here from the BBC. I see I missed quite a lively debate (that’s what I get for watching Holmes on Homes and several episodes of How It’s Made with the hubby when he got home from work).
    Matthew – I think maybe one of the reasons that obesity rates in Mississippi are higher than in Colorado is because of demographics/socio-economic factors. If you compare the populations of the two states and their incomes, you would find a large disparity in income, and you would find that there are more lower-income people of color in MS than in CO. Both of those are leading indicators of obesity – states with higher incomes and fewer POC have lower rates of obesity. Shannon probably has the links with the studies explaining why this is so (I read one of the studies explaining the reasons, but don’t have it bookmarked). As for Americans in general having higher obesity rates than countries in the rest of the world, if you listen to the media in the UK or Australia, or some other countries, they will say that they have the highest rate of obesity in the world – I think that rhetoric is just fear-mongering so that people will accept anything their government says needs to be done in order to “end the obesity epidemic”, even though the rates of obesity have been level for the last 13 years for women and kids, and for the last 9 years for men. After all, it can’t be an epidemic if the rates aren’t increasing and one’s country doesn’t have the most fat people, amirite?

    • Matthew permalink
      February 10, 2012 11:00 am

      Hi Vesta,

      I think your response actually re-enforced my point. I don’t think any race is naturally more prone to obesity than any other, and (relevant but away from the point) the whole idea of “people of color” is as harmful as any other prejudice, as though whites are colorless and therefore non-racial. In terms of economic class, it seems completely counter-intuitive that lower-class people should be the most obese. However, the reason is that lower-class communities have less education about health, less access to fresh produce, quality grocery stores, etc. but they do have have access to Arby’s, McDonald’s and KFC. So, is it in your opinion prejudicial to push for better grocery stores, more produce markets, etc in low-income neighborhoods? Because, in all honesty, to do so implies that the cause of obesity in many people is sociological – in the form of systematic discrimination against certain groups within society-, which contradicts the majority of what I’ve read in the above posts.

      • February 10, 2012 11:14 am

        There is a racial component to obesity, which is why the definitions of obesity in Asian country’s uses a smaller threshold (don’t have time to review it now). There are also racial components to the correlations of metabolic disorders and obesity. People of African descent have a slightly higher threshold for the correlation between BMI range and disease. So, weight effects different races differently.

        As far as the rest of your post, check out the information from the WHO on the social determinants of health. There is definitely a sociological component to health and obesity.


  25. James in Nebraska permalink
    February 10, 2012 1:28 am

    As I posted to the BBC article that brought me here, my wife was not always fat. Before I met her, she was a thin woman. Then she was in a car accident that caused a brain injury. Whilst in the hospital -in a coma-, she gained twenty-five pounds in two and a half weeks. Must have been all those McD Super size meals the hospital was shoving down the feeding tube.

    She is a bit over 200# now; her weight leveled off. When we met, I was 5’10” and 115#. This has a lot to do with the genetics of my family and very little to do with my eating habits, which were atrocious. They were ultimately reflected in my horrid cholesterol scores when I had my first test at age 48.

    My wife imposed a strict low-cholesterol regime which over time has my cholesterol in the normal range. Hers always was.

    And now my weight is gradually creeping up, not because of diet, or because of a lack-of-exercise, but because of my epilepsy medications. Over several years it has climbed from 115# to 140#, which my physician is much happier with.

    But I wonder, will it continue to rise? Will I become the target eventually of such ill-conceived ideas that humiliating or denigrating someone will cause them to change any behaviour?

    Fatter people in our society over the last several decades have had to put up with more and more heaps of discrimination; they get added to others “not like us” such as gays, atheists, or blacks. And discrimination and humiliation are -always- ugly, whilst fat is a fashion opinion that changes over time.

    We will never know how many of the children targeted by these somewhat pervy adverts (who came up with the idea that children should be sexy?) intended to stigmatise them into changing things which they may or may not have a bit of control over, but the suicides that are successful, and the psych med sales to those who are not will be easy to count.

    • GooneRC8 permalink
      February 10, 2012 2:23 am

      Gaining weight as you grow older can be explained by the decreasing forces of natural selection and a reversal to an ancestral phenotype.

      Take a look at this:

      Gaining weight ‘due to genetics’ can be easily avoided by adapting your lifestyle to your phenotypic configurations.

      The big problem is the lack of education on the issue. But being overweight is terribly unhealthy and it is mostly under your control – specially when you are a kid.

      • James in Nebraska permalink
        February 10, 2012 2:50 am

        In my case, gaining weight can be attributed to phenobarbital, a CNS depressant and hypnotic anticonvulsant. In my wife’s case, no neurologist has been able to figure it out (she informs me I was being charitable with that -a bit over 200#, as 250# is not a bit). They do point out that the brain is a much more complicated piece of machinery than what we know now, and that there is no explanation for her weight gain that fits the observed information about her.

        I don’t know how you grew up, but when I was a kid I had zero control over what I ate. That decision was left up to my grandparents (whom I grew up with). We had no vending machines in school, soda and chips were not on the menu, and pizza was a special treat, not a vegetable.

        I understand why schools put vending machines in these days: schools are tight for money, and vending companies pay them money to put them there. The school is left with the unsavoury choice of offering unhealthful snack alternatives or going short on money and offering unhealthful education choices.

        Every single person in my family is on the light weight side, and has very little to do with eating habits. I used to sit and eat an entire pound of M&Ms with ramen noodle soup -in one sitting-. My mother is the poster child for steak, bacon, and eggs for breakfast (she also weighs 115#).

        I used to frequently eat entire pound bags of M&M’s. Three or four times a week. And still managed to fit in my meals in the galley when I was in the Navy (though I might argue that M&M’s are better for you than some of the swill we got).

        But my weight gain started not after I cut the candy out of my diet, not as I aged, but after I started the drug. Weight gain is a particular effect of phenobarbital (imagine if you will if you took a dose of a tranquiliser sufficient to use as anaesthesia every single day for sixteen years). Since it is the only med that works on my seizures, I am stuck with it, and I will take the risk of future alleged health problems of obesity (should it occur) over being run over by a car tomorrow in the street if I collapse.

      • February 10, 2012 4:28 am


        How does gaining weight as you grow older have much at all to do with ancestral phenotype when our ancesters only a few hundred years ago were in “old age” by the time they reached 35? And, most children never reached adulthood/marriagable age? I’ll submit that if people would return to dying of pneumonia, vitamin deficiencies, the plague, or just plain starvation over a bad winter by the time they were 35, they would not have cardiological problems or diabetes when they are 60!

        I was very underweight as a child, mainly from poor parental choices. It wasn’t MY choice on what to eat, or how to eat. My parents gave me what “everybody knows” are “good for you” – ignoring the little fact that I had allergies to various food that made me not digest them. I was force-fed things I chose not to eat, and refused things I wanted to eat. How was this under “my control”? I could not choose what to eat, when to eat, or how much to eat.

        I got older, grew out of some of the food allergies, and was able to eat. By the time I hit puberty, I was pretty “plump”. When I reached adulthood, I was “overweight”. Now, at 5’4″ and 255#, I resemble the women in my family. What a strange world this would be if children did not resemble their parents! My “fat” ancestors lived to ages exceeding 100 for the past several generations. Did my 100 year old, great great grandma, at 4’8″ and 200# die of a “ftness” related disease of a heart attack? Perhaps her younger sister, who was “thin” and died of pneumonia when she was 13 lived a better life? Her death was not related to “fat”.

        In my case, I gained a tremendous amount of weight while being tube fed while in a coma – and I’ll asure you that my insurance company paid far more than $1 for each of those “meals”. Later, I lost around 50 lbs from a case of pneumonia…. and everybody said I looked “healthier” with my oxygen tank! If I’d have weighed 115 lbs, and lost 50, I’d have been dead.

  26. GooneRC8 permalink
    February 10, 2012 2:17 am

    Being ‘morbidly obese’ is 100% the consequence of a stupidly unhealthy lifestyle for 98% of those who fall under that category.

    As an ecologist and evolutionary biologist, I strongly encourage people to avoid processed foods and breads, drink whole milk or no milk at all, have a very active lifestyle, eat nuts, eat avocados, consume vitamin D if living in a winterly place, and avoid sugar at all costs. Also, eat relatively small portions and if still hungry eat another small portion of the same meal later.

    This lifestyle pretty much guarantees fitness. I was pre-diabetic and suffered of hypothyroidism, told I would have to take meds for the rest of my life. I switched my life around by doing as described above, and nowadays I don’t need a single pill and my blood glucose levels and TSH levels are optimal. I’m slim, fast, and athletic.

    You can carry out an unhealthy lifestyle and not be fat, but you can’t carry out a healthy lifestyle and accumulate weight. The ‘controversial’ ads are attacking the problem in children, as they can still turn their life around with relative ease. Being fat is not OK for them, don’t let kids believe that. If I stopped drinking 2 cans of coke everyday (I was pathologically addicted) anyone can.

    • ChrisPalmer permalink
      February 10, 2012 2:44 am

      GooneRC8 – At the least you need to better choose your words. You can carry out a healthy lifestyle and gain weight. Gaining weight is not akin to putting on fat – it could be muscle gain. Likewise in your other comment you saying being overweight is unhealthy, but it surely depends on what the “extra” weight is?

      I repeat an example I used in another comment – that of NFL linemen. Probably all obese by BMI standards yet some of the most active people in the world and healthy for their choice of lifestyle.

      • James in Nebraska permalink
        February 10, 2012 3:14 am

        An “evolutionary” biologist, he says? Is there another kind of biologist that has any traction in scientific endeavour? I am a Romance novel editor these days, and I can figure out that stigma and thinly-veiled bigotry causes suicide and anorexia and bulimia and lots of people on psych drugs and support groups.

        I can figure out that stigma does wonders for driving a diet-programme industry, a drug industry (for psych drugs), and for the fashion industry. I have a high school diploma and I can figure out that. Just as stigma justified targeting blacks, targeting Catholics, it is also used to target “the fatties.” Bigotry always seeks to justify itself by painting “the other” as somehow weak, less intelligent, morally bankrupt, unethical, &c. Just the group has changed, not the tactic.

        For a society that has such a “problem with obesity,” one might ask the good “evolutionary” biologist what the life expectancy of the average US citizen was one hundred years ago, and why all these “fatties” seem to live half again as long as then.

        Perhaps GooneRC8 has never been the target of stigma. My lesbian sister was not driven to suicidal tendencies because she is lesbian, but because of stigma. My ex-wife and baby son’s lives being threatened were not from atheism, but from pickets and death threats, bigotry and stigma.

        Stigma and bigotry are always bad, and do nothing except instill fear and hatred. I only have a high school education, and I can figure this out

        • February 10, 2012 10:20 am

          He (I think) does not take into account that not everyone has access to these good, unprocessed foods. There are “food deserts” in many inner city supermarkets. Also, if one is attempting to stretch their money as far as it can go on a small paycheck, Hamburger Helper, for instance, is going to make people feel full for longer than rice, beans, and avocados. It is not the healthier choice, but it is the more filling choice. Feeling satiated is important.
          Also, in the inner cities, it can be dangerous to go out for a walk, and people do not have access to gyms.
          Most of the people who are suggesting these wonderful ways to lose weight are probably well intentioned but they forget to check their privilege.
          I do not care for the sanctimonious tone taken by GooneRC8. His statement that “Being ‘morbidly obese’ is 100% the consequence of a stupidly unhealthy lifestyle for 98% of those who fall under that category.” is incredibly rude and closed-minded.

  27. Peter permalink
    February 10, 2012 4:22 am

    As a doctor in the US, it pains me to see websites like this. Being obese is not a lifestyle choice, nor is it something to be encouraged.

    Years ago we use to call type 2 diabetes adult onset diabetes. But with kids spending all their time sitting, we had to RENAME DIABETES. This has been in my lifetime, so no, this is not due to genetics. I’ve put children as young as 8 on metformin. Their arteries have aged prematurely owing to their poor lifestyle that obviously learned behavior from their parents (see article below)

    Here are two peer reviewed articles on the effects of childhood obesity, both to you the obese child and to us the general public. There are literally hundreds of articles like these that form what we call ‘evidence based medicine’. This means there is overwhelming evidence to support the view that obesity should be treated.

    To the blogger of this website, do you have ANY published research to support the view that obesity should be maintained?

    • February 10, 2012 9:10 am

      I don’t have time today to respond fully, but I have provided ample research that says that children who attempt to lose weight wind up heavier in the long run. Yes, there are plenty of studies that show a correlation between obesity and metabolic disorders, but our contention is that the causative agent in these diseases is not excess fat per se, but insulin resistance. I will be happy to provide citations later this weekend when I have more time.

      In short, we encourage people to eat healthy and to exercise, but discourage people from using weight loss as the metric by which they measure their health. Instead, we recommend working with your doctor to track your metabolic indicators (blood sugars, lipids and pressure) to track insulin resistance. Any child who has a sedentary lifestyle and eats energy dense foods is at risk for IR, and a doctor who only presumes that their obese patients are at risk is neglecting those kids who may present as “normal” BMI, but whose lifestyle choices are nonetheless harming their health.

      Nobody is saying that obesity “should be maintain.” What we are saying is that healthy lifestyles should be maintained (within an individual’s ability to do so) and that weight should not be used as a proxy for health. I have provided ample citations in comments throughout this post, so feel free to check out those comments in the meantime.


      • Peter permalink
        February 11, 2012 8:55 am

        “What we are saying is that healthy lifestyles should be maintained (within an individual’s ability to do so) and that weight should not be used as a proxy for health.”

        Medicine agrees that BMI shouldn’t be the only proxy, but it is one of the best measures of health that we have.

        A person who does not exercise but is at a healthy BMI is at a lower risk of developing diabetes compared to an obese person who exercises.

        “BMI is more powerful predictor of insulin resistance than physical inactivity” Journal of the American Medical Association

        “Adolescent obesity is associated with increased mortality in middle age”

        “Childhood BMI correlates with adult BMI”

        “a doctor who only presumes that their obese patients are at risk is neglecting those kids who may present as “normal” BMI, but whose lifestyle choices are nonetheless harming their health.”

        Who said anything about letting normal BMI children off the hook? Did anyone say BMI was the end-all be-all of health assessment? A high BMI is like smoking or unprotected sex. A good doctor will try to discourage all unhealthy behavior.

        Of course we tell all children to exercise, regardless of their BMI. However, obesity is an independent risk factor for insulin resistance (diabetes) regardless of your activity level.

        “I have provided ample research that says that children who attempt to lose weight wind up heavier in the long run.”

        I see random citations, some of which does seem like an honest attempt to understand medicine, which I do applaud. But you need to read entire articles and not just pick and choose abstracts from Google Scholar. For example, NHANES clearly DOES demonstrate that obesity prevalence has increased over the last two decades.

        “The prevalence of overweight among children in the United States is continuing to increase, especially among Mexican-American and non-Hispanic black adolescents.”

        “The prevalence of overweight and obesity has increased markedly in the last 2 decades in the United States…The high levels of overweight among children and obesity among adults remain a major public health concern.”

        Meanwhile, here are just a few articles to show that you that weight loss as an independent factor results in better outcomes.

        “family-based weight management program associated with decreased body weight and body fat. Results were sustained for 24 months”

        “residential weight-loss camp significantly reduces body mass index and blood pressure”

        “parenting-skills training appears to be effective for decreasing weight in overweight children”

        Honestly, non-compliant people like you keep me in business, and i don’t much care what you personally decide to do. More of you means more level 3 visits, HHS and DKA, which all means big $$$ for my family.

        You and other “Freethinking Fatties” should at least make an informed decision. I have plenty of patients who are smokers, and they know the risks. So should you.

        • February 11, 2012 1:50 pm

          Listen to yourself, G-d. “Noncompliant”? I would never, ever be a patient of yours if you spoke to me like that. I am in fact a human being, not a lab specimen.

          • Peter permalink
            February 12, 2012 10:39 pm

            “Listen to yourself, G-d. “Noncompliant”? I would never, ever be a patient of yours if you spoke to me like that. I am in fact a human being, not a lab specimen.”

            I’m not sure why you are so offended. I did not make up the term ‘non-compliance’. That is an established medical term to describe people who do not adhere to medical advice.


            I also hope that you will not have to be one of my patients. In fact, I look forward to the day when I’m put out of business, or at least in less demand. I take care of very sick people.

            If you’d prefer to stay out of the hospital, and be not one of my patients, then follow the recommendations of the American Medical Association. Below is some of the material that we doctors learn to try help patients in attaining these goals.


        • Len permalink
          February 12, 2012 5:49 pm

          Peter, I know the risks. I made a choice to exchange my lifestyle of disordered dieting and over-exercising, which played havoc with my physical and mental health, for the tenets of HAES which now have me eating a varied, nutritious diet and exercising for fun, and my metabolic health indicators have improved dramatically. And I am fat.

          Why do I get the impression that if I walked into your surgery with the flu you would immediately decide that I am ‘noncompliant’ and offer me substandard medical care based solely on the premise that I should resume dieting?

          • Peter permalink
            February 12, 2012 10:45 pm

            Congratulations on improving your health!

            Using HAES is much like getting down to 1/2 a pack of cigs a day: it’s a wonderful start, and you’re absolutely healthier for it.

            Having said that, with the support of your family and physician/RD/therapist, etc, you CAN do even better. Keep working hard

            Good luck to you.

          • Len permalink
            February 12, 2012 11:28 pm

            HAES is like smoking 1/2 a pack a day? Zowie.

            I … I hardly know what to say about that.

            Thanks for, er, the rest of your response Peter, which I shall do you the favour of hoping was not intended to sound quite as condescending as it reads.

            I will indeed continue to look after my health to the best of my ability, with the support of my excellent, trustworthy doctor who is far more interested in my long-term health – physical and mental – than in making sweeping assumptions based on my appearance.

            And cheers for the nudge in the direction of ‘doing better’ but given that my current efforts are paying off in terms of real health benefits, I just don’t really have any great desire to revisit my old eating-disordered, exercise-injured, depressed days chasing the fairly pointless goal of weightloss again because a stranger who has never met me assumes their opinion is always correct. I might just stick with myself, my doctor, my friends and exercise buddies and my fantastic physiotherapist.

            Or is that me being ‘noncompliant’?

            Good luck in your continued efforts to persuade vulnerable people to hate themselves enough to ignore health in favour of BMI.

            Righto, I’m off for a swim. Cover your eyes, sensitive souls, fatty in bathers doing laps!

        • Kala permalink
          February 13, 2012 9:47 am

          “Honestly, non-compliant people like you keep me in business, and i don’t much care what you personally decide to do. More of you means more level 3 visits, HHS and DKA, which all means big $$$ for my family.”

          This is an infantile statement, and I think detracts from anything you are trying to say. That you so crassly say to yourself, oh well, at least *I* benefit from the health issues of other people, is pretty pathetic for a doctor.

      • Jackie permalink
        February 12, 2012 7:23 pm

        What if being fat was seen as something to be maintained? What if all drastic weight changes in every body was seen as a bad sign? Peter, can you explain why the lifestyle of a person with Anorexia is typically preribed to fat people under the name of dieting?

        As for this “evidence” based medicine, is it more than correlating fat with diseases? Is it keeping track of only fat people who get Diabetea, instead of thin people who get Diabetes to “prove” being fat leads to Diabetes?

        I think Peter, you need to try and distance yourself from our country’s medcial prejudice towards those who are fat. Many research studies claiming being fat leads to diseases is corollary.

        We have overwhelming evidence that inducing a starvation reaction in someone via dieting, leads the body to believe it’s starving. This sets the body up to store more fat thinking it needs to prepare for future starvation periods. This leads to people becoming fatter not thinner. You and many other doctors are suggesting something good will come of people fighting their genetics. That’s right, weight is a matter of genetics.

        As far as children, suely you realize Peter children grow at different rates. That children may be fat and go through growth spurt. Are you telling us putting growing children on a diet, and depriving them of the food they need to grow is beneficial?

        I also would like to see these children you claim that sit around all day. The majority of children I see can’t stay still for one hot minute. If these children are sitting at home, perhaps you should investigate psychological reasons why that might be happening first. You might be surprised to find that the child is depressed, and has few friends, not because they are fat, because our society encourages fat bullying.

        I feel that telling a child they need to become thin to avoid bullying is a form of victim blaming. It’s not the child’s fault for being born without thin genes, just as much as it’s not a child’s fault if they’re bullied for being disabled.

        Why then do we victim blame fat children? Does it make fat children thin? No it makes children more likely to hide themselves and find comfort in food. Does it encourage fat children to practice healthy habits? I have read articles about 11 year olds developing starvation eating disorders because the schools, The doctors, teach them to fear being fat. When you tell a child they could ie from being fat, they do not have the life experience to have perspective on that situation, they think in black and white terms.

        Peter, you tell me why the hell, (it’s hard for me not use stronger language) we are talking about healthy fat children being horribly diseased, when 11 year olds are killing themselves through starvation because they’re terrified of becomng fat. FIRST DO NO HARM! That means, don’t send children to an early grave by telling them they either STARVE themselves down to a thin weight, or they die of being fat. Don’t you see, the children lose both ways. You care so damn mch about the children, why aren’t your collegues on the news talking about children with Anorexia and Bulemia?! Why aren’t they saying weight stigma is deadly for children, that it causes them to commit suicide? I read the other day about a girl who told Strong4Life her sister tried to kill herself, because a bully told her she was subhuman because she was fat.

        Peter, have you heard of the German horror film Anatomy? It’s storyline was about a group of doctors who were Anti-Hippocratics, they felt they could experiment on patients, and even went as far as plastinating them alive. It was a horror film, so yes the point was made rather dramatically. The point was when you abandon the Hippocratic Oath for any patient, you no longer are a doctor, you are experimenting on people. When you tell children they can choose to die either from being fat, or trying to be thin as their only options you are a Anti-Hippocratic. When you tell a fat patient to get gastric bypass surgeryy, which has proven almost as deadly as plastinating someone alive, you are a Anti-Hippocratic.

        I apologize for having to be so harsh, but this is the truth. I have a Korean doctor who is understanding of HAES. Maybe they don’t require fat stigma as a medical course in Korean schools. How many more people have to die, Peter? How many more people have to DIE trying to attain a unnatural state for their bodies, because the doctors are using ancient medicine to diagnose them. It’s a new century, can we please move past diagnoses by observation only? Can we treat all patients equally, rather than assuming fat is the cause of all ills?

        I think I spent all my Sanity Points for today writing this.

        • Peter permalink
          February 12, 2012 10:38 pm

          You (obese patients) are not the target of a vast conspiracy. We don’t hate obese people, and our research does not unfairly target you.

          “Peter, can you explain why the lifestyle of a person with Anorexia is typically preribed [sic] to fat people under the name of dieting?…FIRST DO NO HARM! That means, don’t send children to an early grave by telling them they either STARVE themselves”

          Anorexia is not a lifestyle, it’s a psychiatric disorder, and we do not prescribe it. We also do not starve children. Your rhetoric is incredible

          You are completely misconstruing what physicians do, much like what the blogger of this site does.

          We advise a 200 calorie deficit per day. The serious medical sequelae of anorexia, ie from actual starvation, does not occur with such a diet. A pound of human fat is about 3600 so this is moderate weight loss. Starving a person implies a severe deficiency in calories, nutrients and vitamin intake. I appreciate that you’re not trained in medicine, but these are serious phrases you are throwing about.

          We healthcare professionals advise weight loss because of all the risk factors that I mentioned in my previous post. There are of course negative consequences of a 200 calorie deficit, and they are similar to quitting smoking: an increase in stress hormones (like cortisol), a SHORT term increase in inflammatory markers (c reactive protein), a bump in liver/pancreatic enzymes, etc. But, the long term benefits of weight loss/smoking cessation clearly outweigh the negatives. That is why everyone from the American Medical Association to the American Academy of Pediatrics recommends loosing weight.

          As advocates of your health, we get frustrated when you don’t listen to us. Anyone who’s seen a person they care about make bad decisions knows what this feels like. I wish I could get all my teens on the pill, all my smokers on the patch, and all the obese on a treadmill.

          Will this all happen? Nope. But should people keep working towards better health? Should smokers keep trying to quit after the 40th time? I think so, that’s why I chose my profession.

          We care about our patients which is why we do all this research in the first place. You all obviously don’t like where evidence based medicine has taken us, but don’t kill the messenger.

          • Len permalink
            February 13, 2012 12:14 am

            ‘As advocates of your health, we get frustrated when you don’t listen to us. Anyone who’s seen a person they care about make bad decisions knows what this feels like. I wish I could get all my teens on the pill, all my smokers on the patch, and all the obese on a treadmill.’

            I take it back. Peter, that is absolutely condescending. If I thought my doctor was referring to me as ‘one of HER “obese”‘ and complaining about me behind my back I would drop her like a hot stone, and be putting in a formal complaint to the medical authorities.

            Happily my doctor doesn’t dehumanise me by referring to me as ‘the obese’. Her care takes the form of a trusting dialogue with me, of discussing evidence-based medicine with me like an adult, of listening to my own health goals and giving me opportunities to ask questions. I allow her to speak her mind about any concerns she has and she allows me to speak mine. We don’t tend to get frustrated with each other because – you know – we have a patient-doctor relationship. I accept her advice and she does me the honour of believing what I tell her.

            And you know what? I put as much credit for my improved health into that relationship as I do into HAES. In fact seeking a trustworthy medical professional is to my mind a crucial step in the HAES process. Such a pity so many of us cannot find somebody like that and instead end up with a succession of condescending people, unable to recognise their own inherent bias, who judge us the second we walk in the door.

            Crucially, I trust that if and when I become sick – as everybody does – my doctor will not smugly lay the blame at my feet and refuse to act as my health advocate because of her own assumptions.

            If you are genuinely frustrated that so many of your patients are not compliant with you Peter, perhaps you might look a little closer to home for the reason?

            Right NOW it’s swim time. I have a lot of energy to work off right now.

          • Jackie permalink
            February 13, 2012 8:30 am

            Peter, it’s not a conspiracy. Also, a professional like you trying to discredit me by pointing out a typo? What are you, 13? It’s the reality fat people face whenever they go to the doctor’s office. Their real health issues are ignored, and only their fat is noticed.

            You’ve done a fine job Peter, of showing why we still need to fight fat prejudice in health care. You talked about us as if we weren’t people, but we were a disease. We’re “The Obese” not individual hukan beings. Would you classify all thin people as “The Skinny”, and give them all the same diagnoses regardless of the real issue at hand?


            This site has first person accounts of fat discrimination in the medical field, this needs to stop. You want to say don’t kill the messenger? You’re a doctor, don’t ypu want to make a difference, instead of being a follower then blaming those which you follow when things go wrong?

            Peter, we don’t listen to doctors like you, because you don’t listen to us. You think anyone here would bother visiting a doctor who claims fat acceptance is nonsense conspiracy theories? As a doctor you need to listen to your patients, that means trusting they know their own bodies, and not condesending or infantilizing them.

            It seems Peter, you have a fondness of pigeonholing your patients. Maybe you need to work on understanding people are more than their bodies. That heling someone involves body and mind. Also, and this is a tough one for many doctors, realizing that human bodies aren’t all the same. People don’t come off a factory line built like cars, but they seem to be diagnosed the same way a mechanic decides what’s wrong with a car. Instead of seeing a person, doctors see only a body that needs to be repaired.

            Your response was condescending and dissmissive, if you didn’t want your beliefs challenged you came to the wrong place. You also are in the wrong p,ace, if you think you can proselytize what us fat people are doing wrong. You Peter, are in the wrong dehumanizing fat patients, among the other groups of people you mentioned. Not all teens are running around having sex you know, I wonder what the parents of your female teen patients would have to say, about your assumption their daughters are being sluts.

            Your correspondance here has been highly unprofessional. If this is what American doctors are being taught, I urge everyone to do their best to find a doctor who wasn’t schooled in this country, which gives doctors high regards if they practice fat discrimination.

  28. vesta44 permalink
    February 10, 2012 11:25 am

    This is slightly off-topic, but is food for thought for those who say obesity is costing us billions of dollars in health care. I read an article today that said orthopedic doctors are prescribing unnecessary tests, to the tune of upwards of $2 billion a year, simply to cover their asses in case of lawsuits ( Now multiply that by other specialties, and I think you can see where some of those excessive health care costs are coming from – and it’s not fat people and their health care.

  29. February 10, 2012 9:27 pm

    I have had my disagreements with HAES, there are aspects I like and others I do not agree with. I had some discussions with HAES leaders.

    I do want to THANK YOU for including this though, as my blog has explored these changes to our society and asked questions about the increase in obesity. I have read even some serious things about plastics affecting hormones recently….

    “But not all obesity is caused by IR. We also live in a world where poverty and education, medication, chronic stress, lack of sleep and our newly emerging understanding of endocrine disruptors in the environment have all been implicated in rising obesity rates. And you know what else has been implicated? Weight cycling.”

    Thank you for presenting that side of things too.

  30. February 10, 2012 9:29 pm

    PS: those posters will not help any children but only harm them. I wrote about that as well. Just more shame and blame and how has that worked for 40 years already?

  31. February 10, 2012 9:34 pm


    Have you considered other effects in making the children fat, instead of assuming it is all “bad behavior” on their part or that of their parents?

    Modern life is toxic, and it’s showing up in health.

    The blame the victims stuff has to stop and hasn’t worked yet.

    I had IR when I was a child, undiagnosed, and was fat despite active lifestyle [mildly fat] with newspaper route and more where I was not sitting on my butt but riding my bicycle hours a day. Covered in brown spots, and more that got worse as I aged and then got even far worse with a giant weight gain.

    IR is from toxins and the endocrine disrupters and bad food. Go to my blog, I have studied these issues in depth as much as a layperson can. I wonder what they are teaching in medical schools now when so many come out thinking the same things, with little insight for the bigger picture.

  32. February 10, 2012 9:38 pm

    I loved this comment from a poster:

    ” You couple that with the reality of modern urban life, life in rabbit hutch apartments with lack of open space and recreational facilities, most of us working in dark cubicle farms all day, then going home to sit in front of the TV or PC for hours and hours. The franken-food combined with the very sedentary lifestyle most of us engage in … is automatically going to make a huge percentage of us overweight. Is it our fault? Sure, undeniably. So what is the answer.”

    I often have wondered what even having a simple yard would do for my health at times. Seriously. Wondering around parking lots and apt buildings, just isn’t the same thing as being able to go outside and garden and DO things. Modern life stinks. I agree about the franken-food. The problem is what happens to those who do not have the money, to find a healthier lifestyle. I am coping with that now.

  33. Tig permalink
    February 11, 2012 2:15 pm

    Apologies if this question has already been asked, but why are there more fat people today than there were a few decades ago? I embrace the concept that we are all different shapes and sizes, and no size or shape is wrong, but why are more of us bigger nowadays?

  34. Jackie permalink
    February 14, 2012 6:32 am

    Why do our schools don’t treat bullying for what it is, a crime. If someone harassed someone over a period of time, a person could go to the police. When a student goes to a dean or principal, they are usually victim blamed. They are told they must change, rather than the bullies being punished.

  35. February 16, 2012 1:32 pm

    The problem is weight & food etc is not the same as smoking. It is not an addiction (for many) and should never be looked at, addressed & handled as such. It is infinitely more complex than that. Handling weight the same way as you would an addiction will only complicate & confuse the matter at hand. Since we keep hearing that little progress towards health has been made in a traditional way, why is there so much opposition to a different approach to health? On a personal note, I have noticed that when I follow HAES (often by accident) I lose a lot of weight unintentionally. -Not that the weight loss is the focus.- But the health sure is! And during those times I am also a lot healthier & happier. Also Interesting to note is that ironically the times when I do lose a lot of weight are the times I have completely let go of trying.

    Why is there such a need to persist in shaming, badgering & condemning heavier people? No one wants to be unhealthy. I sure don’t. And I don’t object to any doctor saying to me: I want you to be healthier- your healthiest self possible and it’s important for you to treat yourself well, to nourish yourself with the healthiest foods possible, and find ways that make you happy to move. Again on a personal note, when on a treadmill I will eke out 20 mins in the name of being healthy, while at a dance rehearsal I will go intensely for hours simply because it is fun. Can we move away from the stigma & need to punish people for weight (and even for that matter people who are dealing with medical issues & illness?) That shame only adds another layer of difficulty. Often keeping people from getting the medical attention they may desperately need. And in my experience stigmatization only backfires- almost always producing the exact opposite of the desired outcome.

    • February 16, 2012 3:54 pm

      i disagree, food is a huge addiction for me and for many. The difference between a food addiction and an addiction to say, alcohol or drugs or smoking, is that you can go cold turkey on those, but you can’t go cold turkey on food because you will die. It’s a substance that is misused as easily as any other.

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    November 12, 2012 6:01 pm

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