The fat acceptance movement has been on my mind lately. See, I agree with most of it: Beautiful bodies come in all shapes and sizes, popular images distort our notions of an "acceptable" figure, it's important to maintain health--doctor visits, good nutrition, exercise--no matter what your weight, and doctors should not bully patients about weight. A person's weight is not a moral issue, nor is it anyone else's business. Women are browbeaten about fitting a thin, perky, fit perfect embodiment of femininity, which is just wrong. I'm sure men must feel pressure to conform to a certain Clark Kent physique, too. Let's all love our bodies!
However, it seems to me that this movement, for all its wonderful and timely points, too often denies the health risks of overweight and obesity. Ignoring the research linking overweight/obesity with heart disease and cancer is like ignoring the research linking smoking with heart disease and cancer. Is excess fat the only cause of disease? No, of course not. It is, nonetheless, a tremendous risk factor, on a par with smoking. Like smoking, fat is difficult but not impossible to change.
I will continue to believe, and to encourage others to believe (when it comes up) that bodies are beautiful in their infinite variety. I would never tell another person that he/she needs to drop a few pounds, and I respect each individual's choices in regards to his/her own body. However, I cannot deny the very serious health risks of overweight and obesity, nor the health benefits of reaching and maintaining a healthy weight. I think that the fat acceptance movement's apparent denial of these health risks is, well, unhealthy. It's one thing to evaluate the risks and say, that's OK, I'd rather not lose weight and take my chances; it's a different thing to say, there are no risks.
And, also, too: Be sure to check out this episode of On Point, a discussion with Susie Orbach, author of Bodies. She has some terrific ideas.
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31 comments:
Oooh! A nerve, you has hit it! :)
I suspect that, in the end, we completely agree with each other. Namely: You should be able to do whatever you want with your body, without judgment. Health and weight is a purely personal and amoral matter. Period.
But, to get into specifics, this is what I believe:
* Fat acceptance folks are into HAES rather than outright denying all health risks of obesity. This is my biggest quibble with your post. It may seem like they're downplaying the risks, but perhaps we're so used to OBESITY EPIDEMIC OMG language that anything less than outright scare tactics sounds like denial. I don't think I've ever read anyone who has said "Obesity is healthy," but perhaps we aren't reading the same fat acceptance stuff.
* Many reports of studies that link obesity and [fill in the blank disease] are flawed and/or overstated. This isn't denial -- it's healthy (heh) skepticism of a culture that literally profits off of an obsession with the "ideal" body.
* Health is more than a matter of physical health. There's also mental health, emotional health, etc. Similarly, as you suggested, physical health is much more than a matter of weight.
* Health-related facts -- not scare tactics -- should be made available to everyone, as should advice on living a healthy lifestyle (including managing stress, handling challenging relationships, getting enough sleep, etc.).
* Said facts should NOT emphasize weight, because weight is technically irrelevant as far as improving one's health is concerned: Thin people can be unhealthy, and fat people can be in perfect health. Plus, health is easier to achieve and maintain and consider than weight loss.
* Said facts (well, food- and exercise-related ones; not so much sleep and stress) are already known by everyone, even fat people. We know how to be healthy. We know what to eat. We know how to exercise. We know all this because it has been hammered into us by magazines, the Internet, TV, ads, movies, news, books, curriculae, friends, family...all of which are influenced by a culture that creates a strong connection between fat and BAD BAD BAD.
* There's no cultural responsibility for healthy lifestyles. I mean, my health club has vending machines stocked with soda and candy, and there's a McDonald's in -- in! -- the hospital. And don't get me started on the health insurance industry. If we really care about collective health, we're going to have to do more than giving it mere lip service.
* There is a prejudice against fat people, women in particular, which makes it difficult for us to support beliefs like HAES, or criticize reporting of weight studies, or, really, talk about food or weight in any way. It can get really complicated and frustrating and emotionally-charged, and nothing ever gets "solved." Which is why I've tended to stay away from these kinds of discussions.
Again, in the end, it's all about what works for the individual. I think it's important to emphasize HAES and fat acceptance not because it'll make people healthier -- though it very well might -- but because it'll make them happier. And, as controversial as it may seem, I care much more about happiness than any number on any scale. Unless it's a scale of HAPPINESS.
Oof! That was a long nerve, indeed!
reposting that comment to chose clearer wording:
Yay, I love discussions!
I can't really reply, because I've already said what I think about it: That although I absolutely agree with you that our culture is nutso about weight and body image, I'm not ready to downplay the link between health and weight. And, for me, health and happiness are linked. Yes, of course physical health is only 1 aspect of health, but it's no better to neglect physical health than to neglect emotional or mental health. In fact, if we buy into Laslow's hierarchy of needs (which is another discussion itself), it would seem that physical health is a necessary foundation before we can have mental or emotional health.
Here's the thing: For me, anyway, changing my eating habits will bring me greater long-term happiness. The cost-benefit analysis falls on the side of Weight Watchers over the eventual possibility of a quadruple bypass, diabetes, high blood pressure, edema, etc.
You may want to travel over to Bitch Ph.D., where there are two recent posts (one by ding, one by m. leblanc) about some of these issues.
Perhaps we're talking past each other a bit. That's OK.
Do I believe that people should attempt to lose weight in order to improve their health? No. Rather, I believe that they should just attempt to improve their health, and weight loss should merely be a side effect.
I just don't see how emphasizing weight loss is at all helpful. I don't think it's a necessary focus, and in fact, it's often detrimental. Concern about appearance, and the social repercussions thereof, instead of health is one reason why so many overweight folks avoid gyms and doctors -- thus contributing to whatever health problems they may already have.
Besides, there are lots of great ways to talk about healthy lifestyles without so much as mentioning weight, ways that would help everyone, unhealthy fat people and unhealthy thin people.
A bigger question: Do I believe that people "should" improve their health? Well...yes and no. I agree that it would make lots of people happier (including me!), sometimes for reasons unrelated to physical health. But my aversion to "should"s in general, when it comes to decisions about one's life that don't affect anyone else, overrides my belief that health is, per se, a Good Thing.
Have I used enough commas and parentheses and hyphens yet?
(Man, I wish there were an "Edit Comment" function...)
In case I haven't made it totally clear yet, I totally support your work to lose weight, and I'm glad it's working for you!
I also wish there were an "Edit comment" button.
Ann, we agree about 99% of all this, we do! I'm tired of all the "shoulds," I want people to have power over their own bodies, and I believe in most of HAES. I agree, there are unhealthy thin people and healthy fat people, BUT, regardless of all of this, there is still a huge (ha ha) correlation between fat and disease. Does that mean everyone should rearrange their lives to lose weight? Not at all.
And it's OK to disagree on this point--or on any of them. It's good to discuss it. I know we completely support each other's decisions regardless of taking different approaches. :)
Narya, thanks for the heads-up! Will check it out.
Can you tell me what you think we should do with this fact, that obesity has health risks? How should we incorporate it into the cultural conversation about health?
Ann, that's a great question. I'll have to think about that! More when I have my brilliant brainstorm. :)
(...I considered pursuing an MPH before going into ESL education. I had a daydream about designing the next Food Pyramid! BTW, in Canada they have a Food Rainbow instead. Pretty!)
OK! I've got something! Maybe we can frame a cultural discourse in terms of body LOVE rather than body ACCEPTANCE. Part of LOVE for one's own body is keeping it in good health! Not saying "Hey, fat body, let's get rid of jiggle," which is cruel and unnecessary, but instead saying, "Body, I care about you and I want us to have a long, healthy life together, so let's work together to reach and maintain a healthy weight."
I prefer, ""Body and brain, I care about you and I want us to have a long, healthy life together, so let's work together to become strong and limber and happy." It's simultaneously more concrete and more comprehensive a goal.
Another question: How do people know when they're at their "ideal" weight? I assume it's different for everyone.
I do like the idea of a food "rainbow." A food "pyramid" sounds sort of grotesque, if you think about it. Pyramids being tombs and all.
There's a lot of wiggle room--there's No One Healthy Weight for a person. Generally, being anywhere within the BMI scale for a healthy weight will do. (In WW, once you lose 10% of your original body weight, you have a private powwow with your meeting leader to determine your ultimate goal weight. If you want your end weight to be outside of the BMI scale healthy weights, you bring in a doctor's note saying it's safe.)
Ew, I didn't even make the pyramid-tomb connection! Have you seen the latest Pyramid? It's not a stepped pyramid with a stick figure running up the steps to emphasize the importance of exercise. For some reason, I find this supremely funny.
Yeah, that's another place we differ. I seriously question the value of any scale that defines this woman as "overweight" and therefore not as healthy than she could be.
I was thinking about "good" reasons that one might want to lose weight vs. become healthier. Here's what I came up with:
* to fit better into seats of various kinds: airplane, theater, office
* to wear particular clothes when the vendor doesn't offer plus sizes
* to more easily tie your shoes and have sex
Right, the difference is, essentially, that I believe the studies that say that excess fat carries serious long-term health risks. If that's true, then it's not really possible to be fat and physically healthy.
The BMI is certainly not perfect; it's a guideline.
PS
(WE NEED AN EDIT COMMENT FXN! ARE YOU LISTENING, BLOGGER?)
Ahem.
I think there are exceptions to every rule, and it's easy to point out that woman and the fat people with perfect blood pressure and the thin people who have heart disease and say, "See? It's all bullshit!" The thing is, every set has outliers.
PPS Sometimes when I think of quitting this whole weight-loss process, I picture my poor heart working so hard, and I imagine the choice of arterial blockages or clear vessels, and I choose the clear vessels and put down the cookie. Of course, I have a lot of heart disease in my family.
Maybe this is just a matter of framing. When you think of arterial blockages, you think of weight. When I think of arterial blockages, I think of cholesterol and a weak heart -- neither of which are directly related to weight.
So when you talk about heart disease, what do you actually mean? High blood pressure? BP is generally a matter of two things: how the heart pumps the blood and how the vessels accommodate it.
Weight makes a difference here in that fat literally presses against the vessels, thus constricting them. (I can add that to my "Good reasons to lose weight" list.) But there's a lot more that can be fixed when it comes to blood pressure: Arteries can be cleared of blockages through healthy eating, and hearts can be strengthened through exercise. Neither of these things would be improved if, for example, you got a liposuction.
So I consider fat as more of a symptom or side effect than a problem in itself. You can't solve symptoms; you have to look at the underlying factors, namely, diet and exercise.
You make good point, but heart disease is just one example. And for weight and heart disease, there is a direct connection: The heart has to work harder when it has to pump blood to more of tissue.
I mean, yes, we can quibble all day over correlation versus causation of disease. If we want to limit the discussion to strict causation, then we have the strain placed on the musculoskeletal system by excess weight and about the aforementioned strain on the heart. If we want to open the discussion to correlation, we have all manner of heart disease, most major cancers, and type 2 diabetes.
Back to BMI for a sec--one problem with BMI measurement is that it is stagewise ("normal," "overweight," "obese," "morbidly obese"). Stages will always create a somewhat arbitrary distinction. My carrying an extra 35 pounds on my frame is not good for my body's health. Yes, it would be worse if I were carrying an extra 100 pounds, and better if I were only carrying an extra 5, even if that meant I was still overweight. There's a sliding scale in there.
I want to take a "time-out" and emphasize that I'm not trying to change your mind or say that your opinion is "wrong," I'm just expressing what I've come to believe is truth.
For now, though, I need to return to my critiquing of second language acquisition! I just finished writing about the ZPD. Onward to Cummins!
PS Overweight people also get yeast infections more frequently.
Even if weight isn't the cause of all these issues, it seems to me that it's a very good indicator of the body's health. :)
Ditto about changing minds or proving "wrong." I've been satisfied with the discussion so far -- it's helped me to clarify and back up my beliefs. No worries!
Again, I think comes down to framing. It makes sense to me to say that fat is an indicator of, or correlated with, ill health. Those kinds of words leave lots of space for exceptions and room for, erm, nuance.
Causation, however, is another matter. My new criteria is: If liposuction can "fix" the problem, it's weight-related. If liposuction won't make a difference, weight is irrelevant.
Oddly, I've never had a yeast infection. That's neither here nor there, of course -- just one little anecdote. Also, possibly TMI.
Good luck with your paper!
Coming up for air between second language acquisition theorists--
I would argue that reaching a healthy weight is a more concrete goal than becoming strong, limber, and healthy. The steps taken to lose weight in a healthy way will cause the other health benefits you cite; the weight loss--the changing numbers--is a measurable outcome of the health & fitness efforts.
I'm going to jump back in to say that, based on something I was reading the other day, BMI was never intended to be used to evaluate individuals' fitness or weight; it's designed to look at groups, not individuals, and will therefore not be all that useful for assessing obesity in a given individual.
Also, I think part of the problem for everyone is defining what counts as "healthy." Someone with a family history of heart disease or diabetes, or both, would perhaps benefit from paying more attention to his or her weight, strength, c-reactive protein, cholesterol, etc.; that person may also incur greater risks of heart attack, say, from carrying an extra 30 pounds, whereas someone with a different history would have to carry an extra 60 pounds to incur the same risks. (Addiction is kind of like that, too: anyone can become an addict, but someone who has addiction in the family history runs a greater risk than, say, I do.)
Coming from a Getting Things Done perspective, we'd break it even further into next actions: Plan meals around veggies. Exercise for at least 30 minutes a day. Stop drinking soda. These things can help everyone become more healthy and for many people will result in weight loss.
In any case, focusing on losing weight, per se, doesn't work. Diets fail; "lose weight" appears on New Years' Resolutions lists over and over. Focusing on incorporating healthy habits into one's daily life has a greater chance of success.
Hence, HAES! It emphasizes health and pleasure, it considers all forms of health (mental, social, physical), and combats guilt and shame by deemphasizing the significance of weight. From this link:
"[T]he HAES approach certainly does not suggest that all people are currently at a weight that is the most healthy for their circumstances. What it strongly purports, however, is that movement toward a healthier lifestyle over time will produce a healthy weight for that person."
Narya: Yes, very true about risk factors. In fact, the NIH web site I linked to on today's new post talks about how to determine whether weight loss would be beneficial for am indivual. It suggests looking at BMI, waist-to-hip ratio, and a list of risk factors.
Ann: Weight loss can work, but perhaps not when approached with a "diet" mentality. That doesn't mean that losing weight can't be the goal. It means not getting into a "bad foods" or a "deprivation" mindset.
One of the things I've learned about myself from WW is that my body had adjusted to consuming--and therefore expecting--more fat and sugar than was healthy to eat. If I had not made the conscious decision to change my eating habits in order to lose weight, I never would have realized this. After a few weeks, my tastes and my body signals in response to food changed.
I have been amazed by those changes in my life. I think that because sugar and fat taste so! good!, it's easy to eat a lot of them and get acclimated to that. But once I started changing that? Wow. Which is not to say that I don't like sugar or fat, mind you, just that I really don't want to eat as much of them as I once did.
Narya, YES! It's also been astounding to learn how much extra fat and salt restaurants dump in food. Take any given dish that would be perfectly healthy & nutritious cooked at home, put it in a restaurant, and WHAMMO!, it's a heart attack on a plate.
Take the dinner we had last night: salmon (grilled outdoors, with a mexican/mole rub/paste), a mix of brown & wild rice, some cauliflower (mostly steamed, then finished in a pan with the caramelized onions), and a salsa made with black beans, the rest of the onions, a mango and a tomato, with a teeny little bit of feta crumbled in it. I know, because we made it, just how much fat/salt was in the whole thing--maybe 1.5 tblsp. of butter or oil in the whole thing, and we didn't even eat all of the stuff that was cooked with fat. At a restaurant, it would have had a ton more fat and salt. (Of course, we probably would have had only one bottle of wine at a restaurant, so there's that.)
Oooh, that dinner sounds GOOD. But yes, a restaurant would have used 8 oz of cheese and sauteed everything in butter.
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