Ironic Ostrich —
Part of the joy of being a Fat Activist includes entertaining the accusations of our critics, who accuse us of “enabling” obesity or promoting unhealthy lifestyles (Warning, those sites are chock full o’ douchebags).
In terms of health, Fat Acceptance generally promotes Health At Every Size®, which says eat healthy foods, exercise and stop using your scale to measure your health or self-worth. To traditionalists, suggesting that your weight matters less than your lifestyle, or that the health and efficacy claims of weight loss are a “cruel optimism”, is tantamount to saying “HERE HAVE THIS CRATE OF TWINKIES!”
But as to the accusation that we are enabling obesity, we are guilty as charged. As a Fat Activist, I hope to enable fat people to live their lives without fear or regret; I hope to enable fat people to pursue the lives they wish to live now, rather than waiting for those last 10 pounds to start living; I hope to enable fat people to pursue health to the best of their abilities and desires without consideration for the concern trolling of strangers; I hope to enable fat people to expand their understanding and appreciation of health and fitness, and to embrace the amazing potential of their bodies; and I hope to enable fat people to see bigotry and hatred for what it is.Throughout this Strong4Life episode, we have repeatedly been accused of ignoring the problem and of not providing any alternative solutions, both of which are demonstrably false. I provided precise reasons why Strong4Life’s ad campaign is wrong and gave an alternative solution in this post here, which neither Strong4Life, nor any of their most vocal defenders, have taken the time to comment on.
My favorite metaphor by far, however, is the ostrich. It always reminds me of the classic Foghorn Leghorn cartoon, “Mother Was a Rooster.”
You won’t be surprised to learn that Strong4Life’s defenders have accused us of being self-serving ostriches:
While I disagree with the ostrich metaphor, I fully support the belief that the only explanation for the ignorance of some of these people is that they must have been beating their heads against a wall for some time before taking to Facebook.
But while Strong4Life has not accused us of being a large, flightless bird, they have insinuated that our concerns are not based in reality.
Now that they have forbidden any mention of their ad campaign on Facebook, Strong4Life has taken it a step further and said that they will not entertain any questions, even outside of Facebook, regarding its ad campaign, which they are now directing at poor, urban neighborhoods.
Okay, so the NIH says there are serious clinical consequences for using stigmatization in anti-obesity ads, but Strong4Life says it will not discuss those consequences. Fair enough. At least they will entertain a robust and complicated discussion about the purported health effects of obesity, right?
On February 2, Strong4Life posted the following link to research on their page, at which time I was still able to comment and I decided to respond to their data with no less than five studies which challenge their assertion.
The following is the full list of research studies and relevant quotes that I provided for Strong4Life:
After posting all of that, I got the following response from Sharyn Muirhead, the very same person who accuses us of sticking our head in the sand:
Okay, so let me get this straight: if we disagree with Strong4Life, then we are sticking our heads in the sand, but if we present a string of research published in national journals, then we are bullying.
For the record, Strong4Life never answered this criticism, and once they scrubbed their site of all of my writing, Sharyn looks appropriately ridiculous.
And this is the first of two attempts at engaging Strong4Life in a discussion of the clinical research. The second was on weight loss:
I also provided research citations here (pardon the inverse pasting… the top item should be the last one I posted), which Strong4Life never answered. And in another thread I started, I challenged Strong4Life yet again to provide a single bit of research that showed significant, long-term weight loss for longer than two years.
Again, no reply.
And when Jennifer Jonassen posted this simple statement, Strong4Life responded once again by attempting to legitimize its strategy with facts:
I then responded to these “facts” with a few facts of my own:
Again, no reply. Finally, I called them out on their inability to respond to my claims:
Finally, after being verbally abused by their defenders and calling Strong4Life out on their hypocritical censorship policy, they said “we have allowed the discussion to proceed despite the fact it is about the ads instead of the medical issue.”
I have now posted a record of my comments on their site, the majority of which were challenges to the “medical issue,” as well as raising a few medical issues that I believed were in play because of the ads. I responded to this final indignation, this final bit of dishonesty, by calling them out on their bullshit with regards to my willingness to discuss “medical issues.” This comment would be the last word Strong4Life would allow from me:
This morning I was reading some research and I came across yet another study that has implications for the “medical issues” that Strong4Life claims to be concerned about.
The article, titled “The Relationship between Overweight in Adolescence and Premature Death in Women” (PDF), written in part by Dr. Walter Willett, a well-respected (among his peers) and outspoken anti-obesity advocate.
And while the study draws the very conclusions one would expect from Willett’s work, including an increased mortality risk for obesity, notwithstanding the rather large error bar for a BMI of 33, as opposed to the more reasonably-sized error bars for BMIs of 27 and under. But there was an interesting tidbit that is overlooked in the abstract:
We also examined BMI at age 18 years in relation to cause-specific death with adjustment for adolescent lifestyle. Hazard ratios for a BMI of 25 kg/m2 or greater compared with a BMI of 18.5 to 21.9 kg/m2 were 1.40 (CI, 0.95 to 2.04) for death due to cancer (258 deaths), 3.24 (CI, 1.59 to 6.59) for death due to cardiovascular disease (55 deaths), 2.13 (CI, 1.34 to 3.37) for death due to other diseases (123 deaths), and 1.83 (CI, 1.18 to 2.81) for death due to external causes (144 deaths). Suicide was the most common cause of external death (61 deaths), and a BMI of 25 kg/m2 or greater at age 18 years was associated with a hazard ratio of 2.31 (CI, 1.20 to 4.42) for death due to suicide compared with a BMI of 18.5 to 21.9 kg/m2. [emphasis mine]
So, cardiovascular deaths due to high adolescent BMI is associated with 55 deaths, while the same factors are associated with 61 successful suicide attempts. For me, the takeaway here is that being fat poses a bigger risk of death from self-harm than from heart disease. In fact, a person with a BMI of 25 or more at the age of 18 is 230% more likely to kill themselves.
Strong4Life, this is the clinical reality of stigmatization, and if you choose to ignore it, then it is you who are sticking your head in the sand, not us.
And before you dismiss this as a one-off study, Willett et. al. go on to explain how their findings on suicide are not isolated:
Our finding that women with high BMI during adolescence had higher suicide mortality rates agrees with previous findings of the association between overweight and suicide attempts in female U.S. high school students.
Meanwhile, he explains how neither being a fat child who becomes a fat adult nor weight gain are implicated as the underlying cause of the mortality risk they found:
Weight gain between age 18 years and baseline was not associated with substantially increased rates of premature death from all causes (hazard ratio, 1.05 [CI, 0.84 to 1.31] for 15-kg weight gain vs. 4-kg weight change, adjusted for BMI at age 18 years and adolescent and adult lifestyle).
In conclusion, our findings indicate that adiposity in adolescence is associated with premature death in younger and middle-aged U.S. women. We observed an increased premature mortality rate for even moderately increased adolescent BMI. This association could not be fully explained by higher adult BMI. [emphases mine]
Introducing the complexity underlying metabolic disorders is not “hiding your head in the sand,” it is acknowledging that our understanding of obesity and health are relatively young compared to most health-related research.
When I have attempted to engage Strong4Life in a discussion of the research, they have ignored me. When the National Institutes of Health condemned their ads as harmful to the health of children, they dismissed their with a patronizing side comment. When intelligent, well-spoken individuals challenged the claims they made on their Facebook page, they banned the Weighty Eight from commenting and forbade any mention of their advertising campaign.
I have been addressing critics on our site openly (and yes, Dr. Peter, I am still planning to respond to your comment) and without reservation. I have provided ample citations for my beliefs and I read the research provided to me by my critics.
It is not we who are sticking our heads in the sand, it is Strong4Life, who refuses to engage in a discussion of the complexities of obesity research, yet when they pop up from time to time to survey the landscape, it is they who say, “*cluck* Where did everybody go?”