It’s All About Choice

I just watched Philadelphia for the first time. Yes, I am way late. Yes, it is freaking fantastic – I’m sure I don’t really need to go into that!

There was one part that really hit me though (besides the whole movie, I mean). In the court room, when the woman with AIDS is testifying and she explains that she got the disease from a blood transfusion.

And then the comment gets made:

So, in your case there was no behaviour on your part… which caused you to be infected with the virus. It was something you were unable to avoid….

…I felt, and I still feel nothing but the deepest sympathy and compassion for people like Melissa who contracted this terrible disease through no fault of their own.

And it just occurred to me – what the hell is it with this argument?? Why is choice the go-to line for anyone trying to justify their prejudice? Gay people choose to be gay, therefore they are bad. Fat people choose to be fat, therefore they are bad. (Yes, this is snark on both counts).

Oh, except for the ones who don’t choose it, you know, the ones who have fat-making diseases or medications (if you believe that) or whatever – they get a special dispensation acceptable-fatty pass.

This is making me so mad right now and it’s late and I’m having trouble being coherent. But someone please tell me – why is it that if we think somebody chose whatever bad thing is happening to them, it’s ok for us to hate them for it?

Thought of The Day

Muffin tops.

Why are they bad?

The top of a muffin is the best bit!!

Random Thoughts

Channel flicking last weekend, I happened to catch a few minutes of a movie called Summer Catch. It was full of actors I recognised, including Jessica Biel, Riley (from Buffy), Buffy’s real-life husband, and Cereal Killer from Hackers. Despite that, it looked terrible, but lucky me happened to catch a full-on FA related few minutes of it. I can’t vouch for the rest of the movie, and I’m not willing to sit through it EVER, so I can’t speak for it as a whole, but the few minutes I saw made me think.

Here’s what I saw. A bunch of guys in a pub, all sitting around a table, drinking beer and eating pretzels or whatever. One guy tells a joke:

What did one fat girl say to the other fat girl?

Who cares – they’re both fat!

Uproarious laughter.

Then Riley (ok, I think in this movie his name was Miles), evidently fed up (which I can only assume means the fat jokes have been going for the whole movie up to this point) climbs up on the table and makes the following impassioned speech:

Excuse me, I am tired of living a lie. I need it to be known that I like a big girl. In fact, a large, zaftig, voluptuous, full-figured, big-boned, massive-assive honey, that is what gets me going. I like fat women and they like me… big girls need love too, baby! Now does anybody have a problem with that?

Everyone in the pub cheers and claps, celebrating the dude’s proclamation.

So, first of all – ewwwwww. Fat girls are fair game for ridicule and hatred, until and unless some guy announces that he wants to bang them? Awesome. I’m not even going to bother going there.

But it did make me think. There are plenty of people out there who are attracted to fat people, who are happily married to fat people who might have been skinny before, and for whom fat doesn’t rate a mention. Sure there are plenty of the haters too – but what would happen if all the non-haters actually called the haters on their bullshit when they saw it?

This is also connected to a lot of the discussion in the Shapely Prose comments thread from the other day.

How do you stand up for fat rights? When is it appropriate to do so? What can you say if you’re a chronic confrontation-avoider like me, and how can you best aim your message so that people don’t get their backs up and actually consider what you’re saying?

Per the movie, for a bunch of drunk d00ds, another d00d standing up and proclaiming that he finds fatties fuckable might be the go – although frankly, depending on the d00ds, this could also lead to never-ending ridicule of the proclaimer.

But of course in reality, no-one climbs on tables to proclaim their fat-love to the world. So if someone says something disparaging to/around you, what do you do?

There’s a girl here who has been on Lite ‘n’ Easy for a few weeks – I see her at lunchtimes with her little baggies. I feel bad for her but I realise it’s not my place to say anything unsolicited.

However, yesterday, she commented to me that she was really hungry, and how that is no good for her diet. So I said “maybe it’s the diet that’s no good for you”. She laughed a bit, and that was it. So while I don’t feel like I can just preach FA to anyone and everyone uninvited, I am starting to try to drop hints now and then. I hope that if I plant enough seeds, maybe one day something will grow.

And when my friend comments about The Uniform Project that its easy to look good when you’re that thin, I say that sure it might be a bit easier, but fat girls can look awesome too, and hey, check out this link.

When I go dress shopping with my sister in law, and she complains about all the dresses looking awful, I make sure to tell her that it is the dresses’ fault, not hers. After all, when she found that fabulous dress among the dreadful ones, her body hadn’t changed, she had just found something that fit her shape right.

I’m lucky that I don’t get exposed to a lot of true fat hatred. I’m not sure why this is, but I’ll take it. So I always wonder what I will do if someone says something truly nasty in my hearing. I think normally my instinct would be to say nothing, perhaps chuckle slightly and hope it goes away.

But that’s not good enough any more, if I really want to help make a difference. For attitudes to change, we need to start speaking up, not just in safe spaces online, but in our everyday lives. And that can be tough. But it can make a difference. I’ve seen this recently with The Husband purely from my occasional introduction of feminist thinking – he now looks at things with a more critical eye. Last night, after he saw the Oreo ad which shows 8 year old boys celebrating their impending bachelorhood, he commented that he thought it was disturbing, and he also sent me a link to the competition being run by EA, to show me how repellent it is. So planting seeds does work sometimes, if the person is willing to challenge their own beliefs.

Of course, not everyone is willing. Some people will cling to their beliefs no matter how much evidence you throw at them (these are the same people who insist that all fatties are lying/delusional about what they eat).

So I’m going to try to start practicing the method that Bee and Starling suggested in the comments thread at SP. I think its confrontational enough to jolt people a little, but it doesn’t open anything for debate. I like to think that just pointing out that their behaviour is unacceptable may eventually trigger a bit of self-reflection (am I kidding myself here?). So from now on, when someone says something which gets my goat, I will say “Stop being an asshole”, or something similar, and promptly change the subject.

The other thing is, recently I find myself wanting to compliment fat girls I see on the train. I saw one at the station the other day rocking a wicked mini-skirt, and I wanted to tell her how much I loved her skirt. I was also walking alongside a deathfat woman on my way to work this morning, who had the most awesome handbag.

Now, I never make comments to random strangers about anything, because I find it creepy when people do this to me (although, that’s because it’s pretty much always men commenting on my breasts). If a stranger commented on your skirt/handbag/shoes/whatever, would this make you feel good/bad/weird or what?? And why do I suddenly want to do this when I never would have before? Is it wrong that I want to let fat girls know that there are people who look at them and see something other than a lazy smelly heart-attack in the making?

Food Hysteria, Pregnancy Style

So now that I’ve started menstruating again, The Husband and I are starting to consider making babies at some stage. And since I’m one of those people who like to research everything and over-think/plan things to death, this has become my latest topic. Yes, I’m crazy that way. I inherited it from my Dad. And I’m one of those crazy hippy types – I already have plans for homebirthing, baby-wearing, breastfeeding, elimination communication and teaching my baby to sign. I also told my Mum that she and Dad should talk to any baby in Italian (they both take lessons) so that baby can be bi-lingual. I’m not sure if she realised I was serious though!

But before that comes the actual growing part, and the attendant food hysteria.

My sister-in-law just recently had a baby, and she avoided so many foods during pregnancy that I thought it would drive me insane. And now that we are thinking about it, I worry that my considerably more lax approach to this is going to be criticised by everyone in comparison to her.

I’m all for avoiding alcohol during pregnancy, although there is evidence now that an occasional drink (not to excess) will not cause any problems. I’m not a big drinker anyway so I don’t imagine this one will be a problem for me. But I will not guilt myself for an occasional sip or half-glass if it happens that I can’t resist.

Coffee, however, I will find hard to go without. At the moment I have a cup each morning, because it helps my brain work (and who ever met a programmer who didn’t love caffeine?!). I have also read that the recommendation on caffeine during pregnancy is not necessarily zero – a moderate amount like 150mg – 300mg has been shown in some studies to have no negative impact, which certainly covers my one cup a day habit. I think I’m inclined to not continue to drink full strength coffee every day during pregnancy – but perhaps I will still have one on occasion. But I certainly have no intention of avoiding chocolate because of its caffeine content, and I will probably drink a cup of decaf coffee or two most days, despite it containing small amounts of caffeine. What do you think?

But then we get to the real obssessiveness. Listeria. It’s the obesity epidemic BOOGAH BOOGAH for pregnant women. My SiL did not eat any cold meats, soft cheeses, cream, or leftovers for the whole 9 months she was pregnant, despite craving some feta and spinach thing that her aunty makes.

Personally, I think this is absurd. Here in Australia, it is illegal to sell unpasteurised dairy products. That means that all our cream and soft cheeses are pasteurised, which means that they cannot possibly contain listeria. Listeria is killed by being heated to 70 C for two minutes – pretty easy to with a microwave if you want to eat leftovers. And aside from all that – want to know how common listeria actually is?

According to the CDC, around 2500 Americans become seriously ill from listeria poisoning each year, and around one third (33%) of these were pregnant women. Given that America has a population of what? 304 million? That means that the chance of a pregnant woman becoming ill with listeriosis is around 0.0000027. That’s one in more than 368 000. So frankly, I don’ think I’ll be stressing about this one too much. Sure, I will make sure my leftovers get frozen quickly and reheated until steaming, and I’ll make sure that dairy products I buy say “pasteurised” on the packaging, in case anything slipped by the Australian food regulation dudes. I won’t eat raw eggs, but since the only thing I would be likely to eat with raw eggs in is chocolate mousse and I make that about once every 3-4 years, I don’t think that will be hard to avoid.

But excuse me if I don’t intend to panic about listeria. If the chance comes along to eat my Mum’s baked lime cheesecake, made with cream cheese and eggs (and then baked), then unlike SiL, I will. Does this make me irresponsible? Am I underestimating the impact these things could have on potential offspring? Or do you believe all the guidelines for pregnant women are overrated?

One Step Forward, Two Steps Back.

Once again I am sadly late actually getting my posts out there despite having started it yesterday, and this has now already been covered by Fat Lot Of Good, Axis Of Fat and Fat Heffalump. Damn you work, for taking my time away from posting! But oh well, I shall post anyways. Maybe I can add something to the discussion.

Why is it that the second something mainstream moves towards a hint of fat acceptance, suddenly every doofus masquerading as a journalist has to trumpet about how we really shouldn’t encourage people to get fat because omg teh fatz is disgusting and makes you die? Oh yes, the “fat is a choice” brigade is out in force today.

GAH. Also – as usual, don’t read the comments on that article. (As Axis Of Fat points out (and The Husband complains about regularly), they selectively publish only the most controversial comments on this site. I’m starting to think their journalists get paid on commission, based on the number of comments their article gets.)

The author of this particular steaming pile of crap is Susie O’Brien, who has been caught out before deliberately lying to readers just to stir up some outrage, and it seems this time is no different, although I’m not sure if this time is deliberate or simply lazy and misinformed.

Right there in the first paragraph, she starts out with ridiculous statistics which she no doubt pulled out of her (righteously skinny) ass:

Why are we suddenly lavishing love on the larger ladies given that half of all Australians are overweight, and one-fifth of us are morbidly obese?

According to the Australian Bureau of Statistics, 37% of us are overweight (BMI 25 to <30). 37% is not half. But then, 25% are obese (BMI > 30). So if you lump overweight and obese together, actually 62% of us are above a “normal” weight. Frankly, I’m surprised that Susie didn’t jump on that with a “nearly two-thirds of all Australians are overweight or obese” line. Shame on you Susie – you call yourself a journalist?

But she immediately rectifies this error by reminding us that one-fifth of us are morbidly obese (BMI > 40). One fifth?!. Given that only one quarter of us are obese (BMI >30) based on the ABS statistics, this seems highly unlikely. Does she really think that people go immediately from overweight to morbidly obese and just skip the 10 BMI points in between?

Although the ABS data doesn’t provide numbers for the prevalence of morbid obesity, the best Australian statistics I’ve been able to find so far put it somewhere around 1%-2%, similar and possibly slightly lower than the rates for underweight people. That’s a far cry from one fifth. Maybe it’s a typo and she really meant to say one fiftieth.

Not to mention the fact that the National Health and Medical Research Council says that

morbidly obese individuals are highly likely to suffer from a genetic defect, with environment playing a permissive role only.

In fact, there’s been yet another study out recently which places the heritability of obesity at 77%. Allow me to translate for you. Most people who are obese (morbidly or otherwise) are that way because of their genetics. There is bugger-all they can do about it. Certainly there will be a few who are this way because of binge/compulsive eating disorders or other “lifestyle choices” (*gag*) but the vast (ha!) majority simply cannot help it, any more than you can help how tall you are.

Susie then carries on with the tired old argument that while seeing fat girls on the catwalk might make people feel better about themselves, we shouldn’t do that because all the fatties will take that as permission to sit on the couch and eat baby donuts and chocolate covered bacon all day, until they have a heart attack and cost the taxpayers tons of money and then die, apparently within the next week or so.

Because after all:

While these women might make us feel better about our bulging butts and guts, the truth is, few women over a size 14 are in a healthy weight range.

And many need encouragement to lose weight instead of being told to feel good about being overweight.

Yes, because we don’t already know that we’re fat. Because there’s not already enough encouragement for us to lose weight. Which world are you living in Susie?

She also says that:

Seeing big girls might give us healthier self-esteem, but it might not encourage us to lead healthier lives.

That just makes my brain hurt. First of all… has no-one ever heard of mental health?? A big part of which is self-esteem? The simple act of encouraging people to have better self-esteem will encourage them to take better care of themselves, by virtue of the fact that they will believe they are worth it. Anyone who has found FA can attest to this. Destroying people to force them to torture themselves to your single numerical definition of healthy is just plain wrong. Starving yourself is not “leading a healthier life”. Excessive exercising is not “leading a healthier life”. Being forever depressed because you don’t look like the societal ideal is not “leading a healthier life”. And frankly, why do we owe it to anyone to live what they consider to be a healthy life anyway? And who says that a healthy life is the same for one person as it is for another? I mean come on people, why can’t we all just stop and think for a minute?!

And don’t give me that argument about fatties owing you good health because they cost so much money. Bullshit. Do you really think that if everyone was just acceptably slim, no-one would get sick? While we’re at it, I think everyone owes it to me to die young, maybe of a heart attack, since that way they’re not going to cost much, because after all, the single biggest risk factor for getting sick (and costing money) is age. So everyone owes it to me not to get old, because I don’t want my taxes to have to pay for your sorry old ass when it gets sick.

And all those people who go gallivanting off in the wilderness and get lost and have to be rescued? They owe it to me to stay home on the couch, because those rescues are expensive. Also, nobody should play sport – how many footballers’ knees have I paid to reconstruct? And I don’t even like football. So stop being sporty everyone. Only make sure you don’t get fat when you stop.

Who gets to decide where it ends?

Frankly, if what you’re doing doesn’t impact me directly, and I mean seriously directly, then everyone should just mind their own damn business. I don’t notice it in my bank balance when we rescue some guy from the wilderness, just like I don’t notice it when some skinny dude gets cancer and costs a fortune in medical bills. It has zero impact on my life. Lets all just adopt the pagan attitude of “and it harm none, do what you will”. My fat doesn’t harm anyone. It is not going to jump out of my pants and mug you in the street. That makes it none of your damn business, just like its none of my business what colour you dye your hair.

I know it’s not fashionable to say this, but some of the women being embraced as positive role models and ambassadors for larger people are obese and should lose weight for health reasons

It’s not fashionable to slag off fat people? Shit, you could have fooled me. I totally thought that was what everyone has been busy doing all these years.

But seriously, Susie, what qualifications do you have that you can so knowledgeably claim that obese people should lose weight for health reasons? Are you a medical doctor? Have you examined these obese people? Have you done extensive research into the health effects of obesity? Or are you just perpetuating that common knowledge which everyone clings so tightly to and never bothers to question with actual, you know, science?

Because if you bother to look, there is plenty of evidence which suggests that it is possible to be both obese and healthy. And just because there is a correlation between obesity and a given disease, doesn’t mean that obesity causes the disease. Say it with me people – correlation does not equal causation. This study and particularly this figure show that obesity isn’t as terrifyingly death-inducing as everyone seems to believe. Overall, there is very little difference between the relative risks of having a normal BMI (18.5 to <25) and that of being overweight (BMI 25 to <30) or obese (BMI 30 to <35). In fact in a lot of cases being overweight or obese is associated with lower risk than being of normal weight. Being morbidly obese (BMI > 35) is associated with higher than normal risk in most cases, but in all these cases being underweight (BMI < 18.5) is associated with greater risk than even being morbidly obese. And since the underweight and morbidly obese make up a similar percentage of the population, and the underweight group has higher overall risk, shouldn’t we be shaming the skinnies into getting fat rather than trying to shame the fatties into getting thin? This would save us more money overall, wouldn’t it??

So it just doesn’t make any sense to also be sending the message that it’s not only OK to be fat, it’s a sign of self-empowerment.

I can’t seriously believe that anyone thinks this is sending the message that being fat is a sign of empowerment. This is sending the message that being fat shouldn’t prevent self-empowerment. You can be empowered and skinny, empowered and normal, or empowered and fat. You do not have to get fat to prove that you are empowered.

Losing weight is hard work. It takes sacrifice and effort. As a mother of three in my late 30s with a new gym membership, I know this first-hand.

It’s much easier to accept the pro-fat manifesto than hit the treadmill.

Oh I’m so sad for you that you’ve had 3 kids and you’re aging and you find it hard to lose weight. That’s because your body wants to be a particular weight. If your new gym membership and all your sacrifice and effort pays off and you lose weight, I will bet that you can’t keep it off for 5 years.

I’m sorry that you’re so bitter about your aging, post-baby body. But just because you can’t love your body, why should we hate ours? Accepting the pro-fat manifesto and hitting the treadmill are not mutually exclusive, and I can tell you that the treadmill is by far the easier option. Accepting that people should be respected and treated as humans regardless of their body size is not easy in a world which continues to vilify fatness. If it were so much easier, everyone would be doing it – after all, 62% of us are lazy and thus can be expected to go for the easier option!

Being fat is not a choice. If it was, do you really think anyone would choose it? With people like Susie slinging shit at us all our lives, why would we choose to stay this way? We wouldn’t. But we do anyway, because it is not a choice. Diets don’t work. Being fat is primarily genetic. It can also be affected by numerous other things including eating disorders, disease and medication. How dare you suggest that 62% of Australians are just too greedy and too damn lazy to get off the couch. If you can find a way to make me thin that is scientifically proven to work and to have only side effects which are beneficial to my health and wellbeing, then it may well become a choice, but until then, stay the hell away from my baby donuts.

But really Susie O’Brien, you were wrong right from the start. Even your title is just plain wrong. You think plus-sized models are doing big girls no favours? Big girls will be big regardless of the size of the models. What the plus-sized models do is help people realize that there are other people around with bodies like theirs, that big girls can still be confident and sexy, and that it is ok to love yourself despite being fat. That’s a pretty big favour, if you ask me.

PCOS – It’s Not Your Fault

So I’ve been taking a high dose progesterone troche for two weeks now, as the first step towards treating my PCOS. And I just want to tell the world – I <3 my progesterone.

Within a few days of taking it, most of my tiredness lifted (I’m hoping the rest will go when we treat the insulin resistance and adrenal exhaustion). I no longer want to cry when the alarm goes off in the morning. I’m way more productive at work, now that I can actually concentrate. I still wake up a lot during the night, but I seem to fall asleep more easily, even though I’m less tired at bed time.

I will admit to being a bit worried about whether progesterone would make me gain weight (some people report this as a side-effect) but frankly considering how much better it has made me feel, it would be totally worth it.

After about 10 days on it, I noticed that my nipples got sore. Kind of weird – I’ve had sore breasts on birth control/before periods before, but never isolated just to the nipples.

And then, after only 14 days on the progesterone… I GOT MY PERIOD. Holy shit.

I haven’t been this excited to get my period since my very first one. Yes, I’m probably weird. But this feels momentous for me, having not had it since February. All hail progesterone. (The excitement is wearing off now – periods are annoying!)

I have to say, the PMS sugar-cravings hit me like a ton of bricks. I haven’t eaten many lollies or much chocolate for a long time, since I legalised them and they lost their appeal. But the last few days that appeal has come back with a vengeance! So now I have a small stash in my office drawer. I’m expecting these cravings will go back to normal shortly, but in the mean time, who wants Skittles and Kit Kats??

All of which brings me to the same place as Sleepydumpling over at Fat Heffalump just went so eloquently. I’d like to join her in whinging about the lack of weight-loss-crazy free PCOS sites. I haven’t been involved in the cysterhood as much as Sleepydumpling, and frankly I’m grateful for it. If I had been diagnosed with PCOS by a different doctor before I found fat acceptance, I can only imagine what my life would be like now. It makes me want to cry. I feel like it’s one of the cruellest jokes the world has ever played on women.

PCOS makes you fat. PCOS makes it hard to lose weight. The only treatment for PCOS is to lose weight. Being fat gives you PCOS.

Anyone see a vicious cycle here??

It’s a cycle of blame and shame, and it’s always the woman’s fault. So the majority of cycster all band together to encourage/blame one another, because they don’t know that there’s any other way. And it makes me so mad.

You do not give yourself PCOS by being fat. PCOS is not self-inflicted. It is an endocrine disorder and is strongly genetic. Please do not beat yourself up about your failure to lose weight – almost nobody can achieve that anyway, even if they are not suffering from a disorder which makes it harder.

Demand treatment from your doctor. If your doctor tells you that all you have to do to cure your PCOS is lose weight – GET A NEW DOCTOR. Find someone who will test and treat your hormone levels, not your waistline. And if for whatever reason you can’t change/go to doctors, if you do nothing else, please, PLEASE, let go of the guilt.

Focus on being happy and healthy, and don’t live your life by the number on your scale. If eating low-GI truly makes you feel better, do it. If it doesn’t, don’t. If you like to exercise, then exercise. If you hate it, for goodness sake, stop!! As many cysters can attest, losing weight is not the cure-all it is made out to be anyway – for some people, it even makes their symptoms worse. So live your life, love yourself, and stop blaming yourself for something which is not your fault.

Fork You!

This is just a rant-fest really, on a couple of things which have got my goat today.

First up, the latest crazy diet – The Fork Diet. I think its supposed to be kind of like the Straw Diet, where you don’t eat anything you can’t get up a straw? Only in this one you don’t eat anything you can’t prepare and eat with a fork. Apparently this will stop you from eating M&Ms.

Now call me a fattie, but I’m positive I could eat M&Ms with a fork. How hard could it be? I mean, I can eat peas with a fork, without even using honey! And remember the Chocolate Game from when you were a kid? Yeah. Stupidest. Diet. EVER.

And while I was chuckling about that, I get this nice email from my employer offering free health checks, wherein they will assess three modifiable cardiovascular disease risk factors – yep, you guessed it – blood pressure, waist-hip ratio and BMI.

Ugh.

Granted this is entirely voluntary (as far as I can tell) and they think they’re doing a service by offering it, but really. Modifiable risk factors?

Ok I’ll cop that you might be able to modify your blood pressure to some extent, although I’m sure for some people high blood pressure is strongly genetic (yeah, my thin Dad has high blood pressure and my fat Mum has low). But the other two? Not so much. I mean, I could change my waist-hip ratio by regular tight-lacing, but I’m pretty sure that’s not what they’re getting at.

And if I do go and get all shocked when they tell me what my BMI is (which I’m not going to, and wouldn’t), are they going to provide me with advice as to how I might permanently modify this risk factor? Seeing as no-one actually knows how to do that, it seems unlikely.

Now, if you were going to recommend a free health check-up thing for a workplace, what do you think should be included?

Obesity in Australia: A Need For Urgent Action

Following is my (very long) take on the Preventative Health Taskforce’s document Obesity in Australia: a need for urgent action. Let me state right now that I make no claims to being a statistical or scientific research expert, so I would love to hear others’ thoughts on this as well, and please correct me if I make faulty arguments!

The Taskforce is an independent advisory panel set up by the Australian Government to investigate current health issues and advise upon approaches to tackling them. From the Taskforce’s website:

The Hon. Nicola Roxon MP, Minister for Health and Ageing, announced the establishment of the Preventative Health Taskforce on 9 April 2008.

The Taskforce will provide evidence-based advice to governments and health providers on preventative health programs and strategies, focusing on the burden of chronic disease currently caused by obesity, tobacco and the excessive consumption of alcohol. The Taskforce will report directly to the Minister for Health and Ageing.

The Taskforce’s key deliverables for 2008-2009 will be to provide the Government with advice on the framework for the Preventative Health Partnerships between the Commonwealth and the State and Territories and to develop a National Preventative Health Strategy.

Obviously, I support what the Government and the Taskforce are trying to achieve in improving the health of all Australians, and I believe that a lot of the recommendations they have for tackling obesity are excellent (although I do wonder if they will actually tackle obesity). However, I am also concerned about some of the language they use and the ideas that they support while making these recommendations.

The Bad

Most of the things that fall under this category are covered in section 2 of the document, looking at the current statistics for and costs related to obesity in Australia.

I’m not going to argue with the actual numbers they give for how many people are currently classified as overweight or obese – I’m sure the numbers are accurate, since by the definitions over overweight (BMI 25>30) and obesity (BMI >=30), people either are or are not. What I do want to discuss is this:

The number of overweight and obese adults increased from 4.6 million in 1989–90 to 5.4 million in 1995, 6.6 million in 2001 and 7.4 million in 2004–05.

I think its misleading for them to quote these statistics without pointing out that the BMI ranges for overweight and obesity were changed in 1998. Actually, from the reference provided for this information, I have been able to track down the associated studies and determined from page 43 of How Australians Measure Up (1995) and page 91 of the 1989-90 National Health Survey published by the Australian Bureau of Statistics that the BMI category definitions used in Australia previously are the same as those used now, so disregard this argument. I’m leaving it in because I think its important for people to be aware that this argument does not relate to Australia, but I believe does still relate to America. Please note that I have no intention of misrepresenting anything!

I do have a lot of questions about the numbers they give as being as a result of being obese. I find it difficult to believe that there is any way to accurately determine how many cases of a disease are a result of obesity, which in my mind means that had this person not been obese, they wouldn’t have got the disease. The reference they give uses
this study as a basis for these numbers, which states that

‘Attributable’ health loss is health loss that is explained by past and current exposure to health risks. This is distinct from ‘avoidable’ health loss, which is health loss that might be averted through future changes in exposure to a health risk.

And in turn this study is based upon the WHO-initiated Comparative Risk Assessment project from 2004.

This publication is extremely long, and I will grant that I haven’t read it all. However, there are a couple of things in it that I’m curious about. First of all, it takes the BMI of ‘optimum health’ (whatever that means) as being 21, based on a study by Shetty & James in 1994. For those who follow this kind of thing, this has been called into question by a more recent study which suggests that BMIs between 25 and 30 actually have lower relative risks than those between 18.5 and 25.

The WHO publication also claims that

mechanisms by which increased bodyweight leads to the induction of cardiovascular diseases and excess mortality are not always clear. The effect is partly related to the frequent concomitant lack of physical fitness and physical activity in the overweight, but it is generally accepted that body-weight gain per se enhances insulin resistance and thus physical inactivity is not the sole explanation(pg 540)

Bolding mine. Although I do not dispute that there is a correlation between obesity and insulin resistance, I do question the causation. And so do others – there is now evidence that insulin resistance causes weight gain rather than weight gain causing insulin resistance, and that type 2 diabetes may be a disease of the gut. From Obesity and Diabetes:

Perhaps the most striking argument against weight loss being the most important factor in promoting diabetes control is the rapidity with which serum glucose returns to normal after gastric bypass, BPD and duodenal switch. This dramatic onset of euglycaemia sometimes occurs within days of surgery, and long before there is any significant weight loss.

I think it’s likely that in different circumstances, either the insulin resistance or the obesity could be the cause. But that makes me suspicious of anything which claims that XYZ people have developed diabetes as a direct result of being fat. Maybe they got fat because they have diabetes.

I also want to discuss the assignation of cost of days lost in the workplace to obesity. The Taskforce says:

Obese employees tend to be absent from work due to illness significantly more often than non-obese workers, and for a longer time, and are more likely than non-obese people to be ‘not in the labour force’.

I would suggest that a good portion of this is related to the fears obese people have of getting medical help. Studies have shown that medical personnel often hold negative views of obese patients, and these attitudes undoubtedly lead to inferior care and/or hostility which encourages obese people to avoid doctors. Would you visit a doctor when you knew they believed you were weak-willed, sloppy and lazy? And then there’s the fact that obese people’s medications are often not calculated to account for their bodies – yes, studies have found no statistical difference between [mortality rate of] obese and non-obese patients who were given chemotherapy based on their body weight. Which they currently aren’t. Yeah, that’s just so wrong.

And as far as obese people being less likely to be in the labour force? I’m going with fatphobia on that one as well. It takes absolutely no stretch of the imagination to picture two candidates for a job, equally experienced, except that one is fat and the other thin – who do you suppose will get the job? I think that if we could eliminate negative attitudes towards fat people (yes, I’m dreaming here), their absences from work due to illness etc would become a non-issue.

They’re also upset that

with the increasing prevalence of overweight and obesity nationwide, it appears that Australians may perceive being overweight as ‘normal’ and hence many overweight people may not consider that they have a problem.

Which frankly, I’m not sure how to approach. I don’t think it’s necessarily a bad thing that overweight people consider themselves normal – maybe they are, and there’s just something wrong with the classification system. Because you can be pretty damn sure that people who are deathfat know it, and they’re the ones who are most likely to have medical problems as a result of their fat. And with the increasing prevalence of extremely underweight people, do you think people who are underweight classify themselves as such?

The Good

On the good side, there are some excellent ideas which I believe will have a positive impact on the health and wellbeing (if not the weight) of Australians, and a couple of points which really, really need to be heard.

First of all, can we please get a press release out on the following? And maybe some billboards, posters, and a giant dirigible (bolding mine).

Food and alcohol play an important part in the social fabric of life, and simply lecturing people or taking a prohibitionist approach is unlikely to be successful or appropriate.

There are a wide range of weight loss programs available…[and w]hile these programs are popular, there is limited data on their effectiveness.

Overall, the evidence suggests that the prevention of obesity is the most realistic, efficient and cost-effective approach for dealing with childhood and adult obesity. This is due to the relative lack of success of treating obesity once it has become established, particularly long-term.

Add to that the following:

There is a clear need to increase the evidence base regarding obesity prevention and management through research, evaluation, monitoring and surveillance. This requires a much higher investment in the research and evaluation of weight reduction interventions and the causes of obesity.

Wait, am I the only one who reads this as ‘we don’t really know why people are fat or how to make them lose weight and we need more research’?!? Can you imagine how amazing that would be? If the Australian Government commits resources to proper obesity research, what will happen when all their studies start showing that it is not as simple as calories in = calories out? Although clearly the Taskforce at least already has some inkling of this, wouldn’t it be wonderful if the general population finally got the message?

Now onto their ideas about what can be done.

There are a wide range of weight loss programs available…[t]o ensure that industry practices are safe and effective, there is a need to review weight loss industry programs and to develop a common code of practice for the industry, covering issues such as costs, counsellor training, and the marketing and promotion of services.

YES. Based on this suggestion by the Taskforce, the Dieticians’ Association of Australia has said that

[A]ll commercial diet programs should be assessed by a body of experts similar to the Therapeutic Goods Administration, which assesses drugs for safety and efficacy before they can go on sale.
[R] regulation should require businesses marketing a diet program to provide evidence to a panel of experts showing what percentage of those who used the diet kept the weight off two years after starting.

And the news report where I got that quote? Said

It follows growing evidence that diets may actually be adding to the obesity crisis as overweight people lose weight rapidly while following programs but quickly put it back on after they stop.

HOLY FLYING SPAGHETTI MONSTER! Imagine what would happen if diet programs had to prove their efficacy! There would be NO MORE DIETS! And aside from my own personal glee at that prospect, I think that banning diet programs and products would make a significant contribution all on its own to the physical and mental health of Australians. Anyone who has been on a diet can attest to the mental strain it causes, and there’s plenty of evidence that yoyo dieting is worse for your health than just staying fat. Plus, it’s possible that this action alone could reduce the obesity epidemic, since the only thing dieting is proven to do is make you gain weight.

They also discuss ways to encourage healthier eating, and consider a ‘fat tax’ as well as suggesting subsidies for healthy foods such as fruit and vegetables. Happily, they point out that it is likely to be far more beneficial to subsidise fruit and vegies than to tax fast foods:

…targeted taxation on unhealthy foods is considered to be regressive as it would impact disproportionately on people and families on lower incomes

Subsidising healthy foods has an advantage in comparison …in that the greatest benefit would go to the most disadvantaged consumers. In addition, research supports interventions encouraging a greater intake of healthy foods rather than policies encouraging a decreased intake of unhealthy foods.

And they also address the need to improve access to these foods for people who are socially and/or geographically disadvantaged, and look at offering tax breaks/subsidies which will improve access to physical activity such as for gym memberships and the purchase of fitness equipment – for everyone, not just the fatties. Hell yes. Government dudes, please make fresh fruits and vegetables available and affordable for all, and improve the affordability of fun recreational activity!

Another idea is to prevent children from being exposed to ‘inappropriate marketing of unhealthy foods and beverages’, which I think is a great idea because frankly, I find exposing children to any kind of marketing somewhat disturbing, especially having just watched a documentary (which I now can’t find to link) about this and realising just how creepy and perverted the children’s advertising world is.

I also love the ideas about reshaping urban environments to encourage physical activity – more parks for people to play in, improved footpaths to encourage walking, bike paths to encourage cycling, the provision of shower and bike parking facilities, and so on. From a purely selfish perspective, I want the bike related stuff – I love to ride, and prefer when I can to ride on bike baths because its safer – I’m not comfortable riding in traffic, and if that was the only option for me, I would never ride. Luckily I am able to get to work via back roads which let me avoid this, but not everyone is so fortunate. Also, showers are great – I have ridden to a workplace without showers before, and cleaned up using baby wipes etc, but showers are so much nicer! Also, I’d be more willing to ride in the rain if showers are available, because that way I have some way to warm up afterwards.

And encouraging workplaces to promote physical activity? Brilliant. Please pass a law which requires that my employer not force me to sit in front of a computer 8 hours a day. I have no idea how that would work, but it would be swell.

And finally, they want to ‘improve public education and information’ and
‘strengthen, upskill and support primary healthcare workers and the public health workforce’. I support both these ideas as well – I don’t think there can ever be such a thing as too much education. I do however think that there’s something important which should be included under these headings – educate people about fatphobia, about how inappropriate and unhelpful it is. Teach people that diets don’t work and that fat (or thin) is not a choice. Teach people fat acceptance.

Because ultimately, one of the things I think will have the biggest affect on the health of Australians as relates to obesity? Is fat acceptance. I think the Taskforce came close, but sadly fell short. If we as a society can learn to accept people as worthwhile human beings regardless of their size, that will go a long way to improving national health. Fat people would be able to visit doctors without fear of being shamed, sent away without treatment, misdiagnosed or mistreated. People wouldn’t diet any more (which I think would have the biggest impact on the obesity epidemic) and their health wouldn’t suffer from continually abusing their bodies. Mental health and self esteem would be drastically improved. I realise that this would not happen quickly since fat-hatred is so deeply ingrained in our society at the moment, but surely it is an admirable goal. That is a world I want to live in.

All in all, I have to say I’m pretty excited by this document. I see this as a semi-public admission that diets don’t work, and that we don’t actually know how to make a fat person permanently skinny. I’m delighted that there are no suggestions of forcing all fatties to have surgery or eat only lettuce, and I think a lot of their ideas are excellent ones regardless of the influence they may have on the national waistline.

So, what do you think of all this? Do you think our Government will be on the right track if they follow these recommendations? Is there anything you would add?

Friday Noms – Felicia Day

Well, I haven’t done Friday Noms in ages, and I really wanted to do Dawn French (who is still coming soon, I promise, since I adore her), but my latest recently-revived girl-crush has got in the way. You know the kind, where you always loved someone but they dropped off your radar for a while, and now that you’ve found them again the love is stronger than ever?

So it is with Felicia Day…

Please excuse me while I get my geek on, big time.

I rediscovered her yesterday through a random video posted on MSN of her new (first?) song, Do You Wanna Date My Avatar, which is totally awesome and hilarious (“you can touch my +5 dexterity chest…” GOLD!). I realised that she is the mastermind of and actress I love and adore from the awesome nerdy web series The Guild, which makes me get my nerd laughter on on par with Red vs Blue (in fact, dare I say better?). And then a friend linked me to her website, complete with blog, and I realised why I love her so much. She has a degree in Mathematics, and her hobbies include video games and reading, particularly science fiction/fantasy. She is a hotter, more famous, American version of me, only she has my dream job (acting – *cries*). Seriously, she’s my twin – I seriously expected her to have the same birthday as me (she doesn’t, but I am undeterred). And is therefore eminently awesome, and should move to Australia so we can be best friends, and she can help me with calculus.

She has tons of book reviews on her site, and may become my go-to recommendations list when I need some new books to read. I also suspect her blog is going on the list of things I read daily (which is already so big that it results in more stuff-reading than actual work) because with quotes like this, it is clearly meant to be.

Oh, Kindle, what have you done to me? I used to read “respectable” high fantasy, things with castles on the covers, 800 pages long with 5 sequels and lots of swordplay. Now I use your anonymous leatherette cover to read vampire and demon lady-porn.

There’s also a video of her playing with the Xbox Natal (yes, I’m jealous), which I am TOTALLY buying for Christmas (please someone promise me it will be out for Christmas!), and an excellent post about writing, with a bunch of great links, and this very profound quote which I will be writing more about soon:

I know the paralyzing fear of being bad very well; it’s one of my greatest weaknesses. For years I had a voice inside me telling I “should” do this and I “should” do that, but I couldn’t overcome the possibility of being horrible to actually risk doing something about it. So I did nothing.

Plus, she has posted on her blog about Orgasmic Pizza—how could anyone possibly not like her??

Felicia, plz send me a message so we can be friends, k?

It’s Official

Finally, I have an official PCOS diagnosis, and a doctor who is actually going to treat it instead of telling me to come back after I’ve been trying to get knocked up for 6 months.

Yesterday I got the results of the multitude of blood and saliva tests that my PCOS-specialising doctor sent me for.

I have high testosterone and DHEA (the testosterone precursor) levels – which is what he bases an official PCOS diagnosis on. Happily, he classifies my case as mild.

I also have excess oestrogen, which is what caused my presentation to be a-typical in that I don’t suffer from a lot of the symptoms of PCOS such as hirsutism, acne, and so on. The oestrogen has been masking the presence of the excess testosterone.

According to the tests, I’ve been ovulating regularly despite not having had a period for over 6 months. I didn’t even know that was possible, but apparently it is!

What’s causing me to not have periods however is a marked lack of progesterone. The doctor said that progesterone and oestrogen levels should be about the same. My oestrogen came back at 22, and my progesterone? Was 0.2. Yeah, it’s lower than it should be by a factor of over 100.

He also did some test which shows what my insulin levels have been for the last three months (I have NO idea how this test works!) and apparently they’re high (insulin resistance), and also unstable. The doctor told me that this can sometimes lead to type 2 diabetes, and assured me that THIS IS GENETIC. Yeah, that’s right baby!

And the icing on the cake? My cortisol levels are very low – I have adrenal exhaustion. Doc says that this is probably the reason why I’m always tired.

Hallelujah for a doctor who actually finds and treats problems!

This doctor believes in a 4 step approach to treating PCOS, and strongly believes that the majority of PCOS is currently being mistreated. He’s starting me off on progesterone supplements, and I have to go back in a couple of months, after which we will look at the insulin and cortisol stuff. Apparently until the oestrogen/progesterone/testosterone thing is normalised, there’s no point trying to fix the other things because the body will not absorb other supplements properly. I’m hopeful that finally being treated will help me feel normal again.

I have to say, I’m kind of irritated that it has taken so long to find someone who was willing to find out exactly what’s going on. Since my sister was diagnosed by ultrasound about 5 years ago, I have asked every doctor I’ve been to about PCOS, if I could have it, and whether I should be tested for it. They pretty much all blew me off – which is ridiculous seeing as PCOS has a strong genetic component. But since I was already on the Pill and not trying to get pregnant, nobody cared. And I’ve been asking doctors about the tiredness (and the weight gain) for just as many years. Thanks for nothing medical people.

The doctor recommended a book to me called The Low GI Guide To Managing PCOS, and I bought it because it has a lot of information about PCOS, and some delicious sounding recipes. I skimmed through it last night, and I have to say it was a mind-bending combination of weight loss diet and HAES. There’s even a part in there that says don’t diet, references to the fact that low kilojoule diets don’t work, cause more problems than they fix, encouragement to eat foods that you love even if they are high GI, and assurances that you don’t have to be perfect, even small changes are good, regardless of their affect on your weight. And yet there was a chapter than seemed to be all about the weight loss stuff – I kind of skipped this one.

But since I’ve been trying to get some lower GI foods into my diet for the last couple of months anyway (and it has a recipe for chocolate and pear muffins), I still bought it. I will continue to try to eat low GI where I can, and I will continue to completely ignore my weight. I kind of got the feeling from this book that the authors believe in HAES and a lower GI diet for its own sake—or maybe that’s my FA bias showing— but felt that they would sell more books if it had something of a weight-loss focus. And from what I’ve seen of PCOS message boards (*shudder*), they’re probably right. Its possibly one of the best diet books I’ve ever had (although I did only skim it, not read and dissect in detail), and I would recommend it for anyone who has PCOS and is trying to lose weight, mostly because I think they would benefit from the messages of “you don’t have to be perfect”, “don’t worry so much about the weight” and “its not your fault”. Has anyone else read this book? Am I deluding myself here?

On a somewhat unrelated note, my sister-in-law seems to have discovered IE during pregnancy (thank goodness!). I went to visit her and the kid yesterday, and while we were celebrating the news story about how our government is considering making weight-low programs and products prove they can help people keep off the kilos long-term (HOLY CRAP that would be fantastic! Maybe another post about this later…) she was talking about how she is now only 3 kilos from her pre-pregnancy weight (4 weeks after the birth) purely from the revolutionary action of eating when she’s hungry, and not eating when she isn’t. And we talked about how diets make people fatter, and obsessed with food, about how people have a set point and how now that we’ve both given up on dieting, chocolate just doesn’t hold that much appeal anymore (this continues to blow my mind). I really, really hope that this sticks with her and she doesn’t go back to weight-obsessed-hell (she is the one who bought her wedding dress a size too small and then had panic attacks when it didn’t fit 6 weeks before her wedding).

So, yesterday was quite awesome, all things considered. Now I’m going to go cross all my fingers and toes and hope that our government passes that brilliant law while I wait for the chemist to mix up my (hopefully life changing) meds!