Lazy=Unhealthy // Fat≠Lazy — Responding to FearBlandness about fat activism

Every once in a while, someone you like says something you disagree with… Or in some cases strongly disagree with.
This is one of those cases.FearBlandness is a skeptic, an activist, feminist, and disabled with an illness that impacts her weight.
With the confluence of those factors, she should understand intimately, that the dominant paradigm is not always trustworthy, or respectful to marginalized groups, that weight is not always a choice, and that the evidence really needs to the the talking, not the culture… Yet somehow she overlooked these things with regards to fat activism.
So, I have left her a very long youtube comment, one that I am not confident she will ever read, with a multitude of citations to get her started looking at the evidence.
I felt, however, that what I wrote goes beyond her as an individual. Thus, I have decided to share it here.

My post itself should be stand alone as you can infer what you need to from context I mention.
I will link her video for those who want to watch it, however, *be forewarned* she believes being fat is unhealthy in and of itself, and the weight-shaming that goes along with believing that is throughout her video.
If speaking negatively about weight impacts you, then *you may be triggered* by this video . <– click there if you wish to see.
Note about the narrative style: The way I’ve written the response is directly to her, and thus is not my usual narrative style as it had a specific person I was directing it at. I’m sure nobody cares, but in case anyone thought it was weird I kept saying “you”, that’s why.
Without further adieu my response to her video, and my post full of citations to studies, attempting to show her what the evidence tells us, which is that lifestyle choices are far more important than weight, in determining health.
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You said in the middle of this video that you can’t understand, hopefully I can shed some light on the topic, if you’re keen to understand. (This will run long, but I’ll try to be concise while covering the important points.)
First, you seem to be confusing 3 movements to do with fat, but all not of which are fat activism or “fativism” as it’s sometimes called.
So, just like Feminism isn’t a monolith, neither is Fat activism–
Group one: fat activists who encourage exercise and healthy lifestyles and say that you should be active no matter your size.
Group two: there are also fat activists who are primarily concerned with acceptance and think people should mind their own business about their weight.
Group three: The people you really seem to dislike and want to call out…Aren’t specifically fat-activists at all.
That group are people who encourage weight gain, are called ‘fat enthusiasts’.
They may sometimes also be fat activists, but their activism isn’t directly related to their fat-enthusiasm.
An equivalent for example, would be conflating atheists who still believe in the super natural, and atheists who are skeptics. Related but not the same.
(Incidentally if you’d like to see a fat activist who speaks primarily from an evidence based perspective, I’d recommend Regan: http://danceswithfat.wordpress.com/2012/04/21/for-fat-patients-and-their-doctors/ )Okay, so now that I’ve gotten that out of the way, I’d like to talk about fat and evidence myself.
You may feel like you already have a good grasp on the studies to do with weight, but I would like you to consider this topic again. This time with your skeptics hat, not accepting the dominant paradigms in our culture just because they are common.
Exercise has been established to have positive health benefits, even for people who are overweight/obese. (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2811477/ & http://www.escardio.org/about/press/press-releases/pr-12/Pages/fitnes-fatness-obese-people-different-prognosis.aspx )
In light of this, the question we need to be asking is:
“Do the other studies which associate weight with health-risks, check for activity level?” Because as we’ve just demonstrated it’s an important vector.
Not accounting for that is like trying to research sleep disorders and most of your participants drink coffee but you aren’t accounting for that.
The answer is, typically no, they don’t.
The studies that do separate overweight people who are inactive, from those which are active, have found that obese people who had healthy lifestyles did not have the added health risks. However, they were more prone to them when they had any added unhealthy habits, unlike their thin peers who could have a few unhealthy habits and still have a lower morbidity rate.
Here’s one of the most famous studies on the matter, which was conducted over the course of 14 years.  ( http://www.jabfm.org/content/25/1/9.full )
We don’t know why that is, because very few studies have been done on the differences between overweight active people and overweight inactive people as of yet. As far as I know, just the one I linked up there, and it’s focus was very broad, just overall health.
These aren’t the things that dominate the conversation about health and weight though, the talk about exercise and lifestyle that is.
The dominant conversation about weight is instead: Fat=Unhealthy and this is not an evidence based opinion. Why? Because there’s no evidence that weight, in and of itself, causes health problems.
There is a correlation/causation fallacy which is generally accepted in conversations about weight, which is “obesity causes health risks” <– that statement needs to be supported by evidence, as yet it is not.
Correlation is not causation, and obesity has not been established as causal for any health problems. Lifestyle choices, some of which can potentially cause obesity, have.

Again back to exercise, which has excellent for all sorts of health benefits, but something important to understand is it’s not a guarantee of weight loss.
We also don’t actually know how many obese people have a healthy lifestyle or not, because there hasn’t been a study on that, yet.
Studies on benefits of weight loss that don’t mention how the weight is lost, do not paint a clear picture. Because we already know that exercise is it’s own health benefit, and it’s possible that the weight loss is a side effect, not a benefit in and of itself.
We know that diets on their own have been shown to be ineffective (They link the actual study, but I found the article itself informative: http://newsroom.ucla.edu/portal/ucla/dieting-does-not-work-ucla-researchers-7832.aspx) and sometimes harmful.There is also a derth of evidence that everyone can simply lose weight.
Even calories aren’t the magic bullet, we know this from the study which found overweight teens were eating less than their peers.(http://www.sciencedaily.com/releases/2012/09/120910082135.htm)
And what causes weight gain is still a topic that is being explored too.
Eating extra calories certainly isn’t the only factor in being overweight.
As I’m sure you’ve read, sleep has an impact. (http://www.ncbi.nlm.nih.gov/pubmed/16914506?dopt=Citation)

You also asked ‘what’s the point of fat activism?’ The point is that encouraging people to not judge health by weight, and in the case of fat activists who support ‘health at every size’ narratives, the point is to encourage people to develop healthy habits without worrying about weight.
The focus is currently almost entirely on weight, and the conversation is hurting the health of fat people rather than helping it. (http://www.cbc.ca/whitecoat/2013/09/27/medicines-big-fat-bias/)
It’s also potentially also causing people to get fatter and more unhealthy.
(They link the study in the first couple paragraphs, but it’s another one where I liked the article: http://www.nbcnews.com/health/diet-fitness/fat-shaming-actually-increases-risk-becoming-or-staying-obese-new-f8C10751491)If instead we say “it’s okay to be fat, but you should be active” then we can encourage a health lifestyle, which all the evidence suggests is the most important vector with concerns to mortality rates. We put the focus where is should be.
On the evidence based health conversation and not on if someone is fat or not.

Honestly, I doubt that any person who is not already fat, or without a fat-oriented paraphilia is going to desire to be fat. Those people who are and can not lose weight, should not have to be inundated with messages that they are lazy cake eaters who just need to buck up go exercise…. Because that they may not be any of those things, and they may even be a “fathlete”.

I hope you understand, as a skeptic, why looking at the evidence is very important in this topic… and perhaps that you have a clearer understanding that very few people who consider themselves fat activists are actually advocating being fat.
And also that poor lifestyle choices, rather than the weight specifically are the best (read: most supported by the evidence) predictor of health.
Basically: Lazy=Unhealthy // Fat≠Lazy

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In addition to this I want to say that I’ve never heard of a fat activist denying that there are correlations with health risks.
However, I’d like to repeat for good measure and emphasis, that correlation is not causation.

I think we need a social paradigm shift on the topic of weight and health, but the take home point is something everyone can benefit from, even if they aren’t overweight, and no matter what they think of weight in relation to health.
Certainly I do not have to be a fat activist to see it’s benefits. (Wait, does making this post mean I am one?… Maybe.)

That take home point: Try to live a healthy lifestyle. If you have to chose just one focus, then be active, to the best of your ability, no matter what size you are.

Now who could disagree with that sentiment? 😉

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9 thoughts on “Lazy=Unhealthy // Fat≠Lazy — Responding to FearBlandness about fat activism

  1. I watched part of her video, and see the pros and cons in most everything. (Something I’ve learned to do and be after a handful of college years and being a student: objectivity and remaining neutral and without bias. It’s helped me tremendously to see both sides in all things.)

    Thanks for sharing this and for doing much needed research.

    p.s. I thought of you last night as I spent the night watching Netflix, relaxing, and eating 7 mandarin oranges. ;0)

  2. p.s. Perhaps you can share this enlightening article about the possible dangers of wearing make-up:

    according to her, it is a burden when someone uses the ambulance to go to the hospital when he or she has OD’d on alcohol (or has engaged in some other behavior that could have been prevented) but really, aren’t many health problems preventable, practically? In the beginning stages, most can be considered “preventable” if the person’s habits change. But, most of us don’t adhere to shockingly healthy habits, so, we kick up the risk factors of many illnesses, diseases, and injuries simply by “living”.

    Maybe you can share this with her: http://www.minbcnews.com/news/story.aspx?id=679100#.UwJ1U2JdVOo

    In the article, wearing eye shadow and make-up can and may cause cancer. I noticed she’s (Fearblandness) wearing bright purple eye shadow. I imagine the chances of her getting cancer from her eye shadow are slim to none, but- she’s engaging in a behavior (daily) that can absolutely increase her chances of cancer.

    If someone (such as her) is going to stand firm on his or her principles- such as “promoting good health and raising awareness in health care issues, etc.” then they must adhere to its codes and policies all the way around. Otherwise, it’s a bit hypocritical, you know? So, for me, she is the pot calling the kettle black.

    • Ah-haha — Well I’m very glad to be remembered. I hope you enjoyed your oranges and netflix. ;D
      (I was reading that you’d had a very rotten week, but that things are improving, you have my hopes that they continue to improve. Sometimes luck is a cruel mistress.)

      That’s a good point. Quite a number of her own seemingly innocuous habits could definitely contribute to her overall health, in the same way that food choices might do for overweight people.
      It gives me a certain kind of solidarity based validation to see other parts of her argument, the ones I didn’t address, get holes poked in them. 🙂

      I probably won’t try to call her on it though, I want to make sure that she knows it’s not about her faults versus their faults, where she might be able to argue proportional harm, and other wallet based bigotry.
      To make a point stick, I think it’s got to be about the evidence she lacks .
      Mostly I’m just hoping she will realize her bias isn’t based in facts, it’s emotional and cultural.
      If all that amounts to is that she never fat-shames again, but doesn’t speak of the topic, I’d be okay with that.
      Than she can lifestyle shame if she really wants to, and that would be the time for the hypocrisy arguments to be leveled, as it’s bloody clear that nobody is perfect, and not everybody can even manage a fully healthy lifestyle. (Certainly she can’t, she’s got muscular dystrophy)
      I always want to ask, are we sure all these people were fat and then became sick? Or is it possible, that they were sick and then became fat when it got hard to move around and do things because of their illness?

      I know for me I gained weight from feeling unable to go outside. I used to walk as my primary source of exercise, when I didn’t feel I could do that, I gained weight (of course)
      I was sick first.
      How many other people are sick first?
      And if they are, then we’re definitely looking at this from the wrong way round.

  3. This was a totally awesome post! Thank you so much!!!
    One of my doctors is fairly obsessed with my weight. (So are my parents, but they border on ED, especially mum, so I’ll leave them out of it.) Once I’m back on track with my exercise, if he starts up about it again – it’s that medications bloke you hear me whining about so much! – I’ll be able to counter his remarks with some of the evidence you’ve presented here.
    I’m truly grateful for this post, and the amount of research which went into it. Thank you. XX DB

    • Excellent! 😀 You are most welcome, and I’m glad to be of help.
      But also ‘Uhhg’, sounds like he might be a jerk.

      I hope you’re able to shut him down about it. It’s really not fun to be chastised for no good reason.
      If he tries to put up a fuss, point out that it’s not his expertise, and ask him to show you where it was established as *causal* of anything you could possibly suffer from. He can’t, of course. So that should hopefully give him a run for his money. 😉

      The thing that drives me crazy about doctors and studies, (and I’m sorry this is a little ranty) is doctors have to take a science class at some point, and so should know better. Yet, they still fall prey to trying to use studies without understanding how science works.

      Methodology is the most important factor in how much sway a study should be awarded, or not.
      Studies that don’t have a specific enough ‘subject'(which can be a trait of phenomena), and studies where the hypothesis has an ingrained bias which causes ‘framing’ of the data, produce less trustworthy results, less scientific ‘science’.
      Those studies are not equal in ‘trustworthiness’ footing as studies that attempt to account for as many intersecting factors, including human errors such as framing, as possible.
      Not making a distinction between those two means there are physicians putting stock in, and applying in their practice, methodologically unsound science.

      Doctors have the added detriment of being used to their positions of authority, and being authoritative in their knowledge base… but they simply aren’t always ‘up’ on everything, this is why their are specialties among the medical field itself on top of the fact that medicine is a specialized field.
      Doing the bioinformatics research is required to learn the facts, but understanding at least the basics about methodology is required to know how much trust can be put in a study.
      But it isn’t a requirement of the job, and many doctors may not have bothered on either count.

      They are people, fallible as any of us, and swayed by the culture around them, even into having biases in their work. :\
      [/rant] Sorry ’bout that, sometimes I just feel batty.

      • No probs 🙂 You should hear my husband on the topic! Of this particular doctor, that is.
        But sadly your comments hold true across much of the profession.
        I said to my therapist yesterday, “Seriously, I need some new men in my life … not you!” because a shadow crossed his face. I’ve got a medications bloke who keeps mucking me around (but whom I’m currently bound to because I’m trying to make an insurance claim and need him for that) and a GP who recently told me gynaecology was his least favourite subject at medical school … so, I think to myself, do I really want him as my doctor? Ah well, he bulk bills me, I can always get in to see him, and there’s a female doctor in his practice who does my pap smears etc.
        Sometimes I understand why people throw their hands up in disgust and go for alternative medicinal treatments.

      • Haha- I’ll bet you’re beloved has got some real storm-clouds brewing for that one. XD
        Oooh boy, sounds like you’re working with a bit of a tough crowd for a health team. Well, at least there’s another doctor at your GP’s practice who can look after the womanly bits.

        I wish it were a real alternative, but it’s got even less evidence behind it (most often none at all) than even the old science the physicians are spouting.
        My parents, especially my mom, were into alternative medicine, so I was raised with all sorts of it. Sadly, it’s not better. You might expect the practitioners to at least be nicer, but no, in my experience you get about the same amount of crabby authoritarians, only with even less grasp on reality than regular doc’s. :\
        With the added detriment that the people here who buy into it, act arrogant about it.

        A real alternative needs to be made I think, one with practitioners bedside manner being part of the grading, and “Evidence based” and “People first” as part of the mission statement. 🙂

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