Sunday 6 January 2013

Weighty Matters

This post is partly about my plans for my health in the New Year, and partly a response to and discussion of recent articles and studies on the subject of obesity, including:

Association of All-Cause Mortality with Overweight and Obesity 

"Weight is healthy" study criticised 

Obese and unhealthy people could face benefit cuts

Benefit cuts for the obese are driven by fat panic and class hatred


 If it seems a little disjointed I apologise, I compiled it from several comments I have posted elsewhere on this topic.


This year for once I am not vowing to tackle my weight by dieting, my energy levels by trying to force myself to be more active, or my mood by trying to force myself to believe fake happier thoughts. I have decided that today (and quite possibly every year from now on) is a year for TLC.

So my resolutions are- to eat plenty of really nutritious food, to take the rest I need as best I can considering my other commitments, to take care of myself with gentle country strolls and do a little bit of physio most days instead of trying to do more and then crashing, and to work on mindfulness and acceptance of my pain and fatigue as in the book "Living Well with Pain and Illness". I'm hoping to take the associated Breathworks course sometime this year.

I think a Health at Every Size approach to my weight, eating and health is more likely to bear fruit. Research has shown that it is a myth that fat= unhealthy and thin=healthy, and encouraging people to focus on dieting and weightloss is not associated with improvements in health. Weight cycling is prioven to be harmful to health outcomes, and those who have recently lost weight actually have higher mortality rates than those who remain fat. I also think that thin people should not be led to believe that because they are thin, they don't need to concern themselves with their diet and health!

Dieting is not the answer, diets don't work, 95% of people who diet end up gaining back whatever they lose and often more. Weight Watchers is the answer? Don't make me laugh! They consider you a success if you keep 5lbs off for a couple of years!
 
How about eating a healthy meal because it makes you feel good and because you want to care for your body by feeding it well? Or finding an activity you enjoy instead of forcing yourself to do exercise you hate and then giving it up when it doesn't bring you sustained weightloss? These should not be radical suggestions!

For those reading who have succeeded at long term weightloss, kudos to you. But the fact is that for the majority, willpower is not the answer. Our bodies are designed to eat food and store fat when food is plentiful, and the calorie laden fake foods now widely, and cheaply, available only contribute to this. Food company staff discuss how to make their foods more "craveable" and deliberately design them to be rapidly digested and utlised by the body to leave you needing to eat again at the earliest opportunity. Those drives are very powerful. I don't have all the answers, but I do know that lifelong dieting is not going to work for most people. If you don't believe me, open your eyes, is it working?

And for those who think that shaming fat people in the answer, I ask you- when has shame and self-disgust ever been a good motivator for positive change and self-care? Hating your body is not a good motivator for taking loving care of it.

So yes, numerous studies have shown that weight or BMI is meaningless as an indicator of the health of an individual. Statistics cannot show that intentionally reducing BMI will make an individual healthier, even if that person is able to achieve that. If BMI is such a meaningful indicator, I'd like to know why underweight people are not endlessly lectured to gain weight and tutted at if they are seen eating salads! It'd only be right! Yet we do not see that happening. An underweight person may be asked whether they eat normally, if the reply is yes then the doctor is satisfied. Yet a fat person would not even be believed if they say they eat a generally healthy diet or that they are active.

Prejudice and fat phobia are not an appropriate motivation or basis for deciding on health advice or medical treatment. Fat people already receive less adequate treatment that thinner people, often being told that their weight is the cause of their problems, or that weightloss is the main solution for symptoms of conditions ranging from arthritis or CFS to, yes, you guessed it, hypermobility syndrome. Hence, instead of examining me thoroughly and recommending a program of specific exercices to target my weak and problematic joints, my physio has told me to "focus on cardio and weightloss".

A health at every size approach and body acceptance improves health. Weight stigma, body shaming and dieting does not. Please see Size acceptance and intuitive eating improve health for obese, female chronic dieters and Weight science: evaluating the evidence for a paradigm shift

I have to ask- why are many people so determined that the status quo- body shaming, dieting and the insistance that thin= healthy- must be maintained, even in the face of the growing body of evidence stating otherwise? I can only conclude that prejudice and fat phobia, whether conscious or not, is at work. Comments like this one, from the National Obesity Forum, quoted in the recent BBC new article I linked to above, seem to support my theory: "We shouldn't take it for granted that we can cancel the gym, that we can eat ourselves to death with black forest gateaux". Also note the dehumanising "headless fatty" picutres which accompany almost every article about obesity, only occasionally replaced by the equally offensive "personless mouth" usually pictured with some kind of unpleasant looking and oversized piece of junk food looming in the foreground.

These cultural ideas (and ideals) are so entrenched in us that even once we have informed ourselves, they are hard to escape from. How many times have I said that I can't go hungry as it affects me too badly? Many times. Yet after a few days of thinking about my plans for the new Year, I have realised how often I do go hungry, by doing sneaky things like going into town without having a snack, knowing I'll be out until lunchtime and famished to the point of feeling dizzy and nauseous when I get home- and naughtiest of all, it's partly in hope of losing weight... LOL walk the talk woman, do you really want to succumb to a culture that keeps women hungry and ineffective? No! 

Every individual has the responsibility to ensure that they are well informed before holding forth with an opinion, and certainly before taking a role in health decisions or policy-making. The media, the NHS, medical professionals, fitness professionals and so on should not be commenting on, advising or treating people based on outdated, disproven ideas. And as individuals we have responsibility too, toward ourselves and to the wider community. I for one will not be basing my health decisions this year on unscientific and prejudiced information.