In sickness and in health

I currently have a hideous cold, and it’s the second in a month.

This isn’t in itself particularly remarkable: humans get colds, I’m a human. It’s winter. Some cold seasons are worse than others.

But I’m second-guessing myself. This happens each time I become ill, or each time I have an injury or an ache that takes more time than usual to go away. My self talk starts up: why am I so unhealthy? What is wrong with my body? My body isn’t as good as other people’s. Maybe I need to eat more broccoli. Maybe I need to eat less broccoli. Maybe I need a new mattress on my bed. Perhaps this supplement will help. If I just went to the gym a bit more regularly… if I just (ding ding ding here it comes) lost some weight. No, scratch that, I know that’s not the answer. But maybe if I did go to the gym a bit more… et cetera et cetera you get the idea.

Thing is, it’s just a freakin’ cold, people.

It is possible that I’ve been cold-prone lately because I’ve been tired and a bit stressed and yes, I haven’t been to the gym so much because I’ve got a problem with my foot and I’ve been busy and also, life. So it’s not outside of the realms of possibility that I could positively influence my levels of immunity and general health by taking better care of myself.
But, it’s just a freakin’ cold. It’s not a moral failing. It’s not an existential crisis. It shouldn’t make me feel this bad.

Living in a fat body (which is pathologised) and a cis woman’s body (which is frequently pathologised, particularly when it comes to reproductive system related happenings) and a mentally ill body (which is pathologised), is it any wonder that I feel anxiety about my health? And, living in this culture which tells us all the time that good health is a sign of good character and something which anyone can achieve if they just try hard enough, it’s hard not to feel like an epic failure when one doesn’t exhibit a ‘healthy glow’.

For me, this seems to be a fairly old pattern. Mistrust of my own body and, perhaps more importantly, my ability to manage my own body, runs deep.

I have no doubt that this is in large part because of fat stigma. The message we receive from the media, popular culture and even medical discourse about fatness is that it is a sign of lack of control. It’s a failure of willpower. It’s greed. It’s a literal overstepping of bounds.

One of the problems with this as that feeling as though your body is unmanageable and unruly actually makes it far harder to take steps to manage (for want of a better word) your health. It takes away any external incentive to take care of yourself (why bother if everyone thinks you’re unhealthy anyway?) whilst simultaneously destroying your internal motivation. It does this by encouraging you to hate yourself.

And guess what? Hating yourself can make you sick. It’s also seriously lacking in fun.

I’m not saying that an end to self-loathing is a cure for the common cold. But it’s pretty obvious to me that as a society we have come to a place of collective mistrust of our bodies. Any birth choices or breastfeeding advocate can sense this. And some of the people who are most vulnerable to internalising negative messages about their bodies (and to lose confidence in their ability to take charge of their own health) fat people, especially fat children. (No surprise then, that fat people are so often infantilised by media messaging, too. Grow up and take responsibility for yourself, fatty!)

We have come to this terribly contradictory impasse where we are simultaneously told to ‘take responsibility’ for our health and weight and discouraged from trusting ourselves or listening to our own appetites or bodily needs. The result is a horribly sizeist, healthist, ableist way of thinking and a truckload of stigmatisation.

And feeling guilty for having a freakin’ cold, people.

I’m trying to resist that mess, but it’s not easy. Sometimes, kindness towards oneself is actually the harder road to take.

I am not your cautionary tale

In some ways fat bodies are our current culture’s dumping ground for fear and loathing: we are the go-to places for thrashing out anxiety about consumption and excess, death and disease, work ethic and individual responsibility, boundaries and restraint, ugliness and beauty. Fat bodies are politicised — even politicians literally use fat as short-hand for bad, wrong, excessive. Fat bodies are ridiculed, dehumanised, demonised and charged with meaning.

All of this is, perhaps, largely academic. I’m a fat activist, of sorts, but most days I’m not overtly doing activism. Most days I’m buying bread and milk and taking my daughter to playdates and watching Dexter and, you know, living.

Except my life is lived in this body, which is fat, and when I am buying my bread and milk etc. I am visibly fat and when I am existing I am inhabiting a politicised body.

Today writer John Birmingham had a column in the Brisbane Times about The Biggest Loser. He gave this nod to fat acceptance:

Obesity is an intensely politicised topic… Traducing someone’s character, or mocking them for their weight, isn’t far removed from doing the same things on the basis of their skin color or ethnic background. Grown-ups should be above it.

He also mischaracterised the fat acceptance movement, I think, as angry and somehow ‘dangerous’ as well as misguided about health. But that’s not what I want to write about. What struck me most about his piece was the admission that he views the “freakshow” elements of The Biggest Loser as useful parenting tools.

I wanted [my kids] to feel disgust at the carefully calibrated circus presented for us by the program’s producers. Why? Because as a parent fresh fruit, oatmeal for breakfast, drinking lots of water, and playing sport rather than Nintendo DS, is a hell of a hard sell. The grotesque obesity on display in Biggest Loser makes explaining the benefits of good nutrition and exercise that much easier. Harsh and ugly, but true.

You know, I have some sympathy for Birmingham’s position as a parent who is trying to instill healthful habits in children who are presumably bombarded with “junk food” advertising and the lure of screen time, like the rest of us. Bean is very active, in touch with her natural appetite, and in love with the existence of fresh fruit but she is also not-yet-three and so I willingly accept that what has been a breeze for me may require more conscious effort in coming years (although I am of course hoping that our early approach will continue to help Bean have a healthy and peaceful relationship with food and activity as she grows). I certainly don’t feel that modeling any kind of body-shaming — of her body or others’ — will ever form part of my parenting strategy. Fat-shaming children is harmful and I know I could never be convinced otherwise, despite how hard I work not to be overly judgmental about the parenting decisions of others.

But, to be frank, I find it quite chilling that the “grotesque obesity” played up for the cameras on ‘reality’ TV could be masquerading as a fable for children in homes across the world. Look kids, you don’t want to be so big and wobbly and disgusting that they put you on television, do you? Chilling because it normalises fat stigma and body shame (wouldn’t it be better to normalise diversity and acceptance?) but also because it is a reminder, to me, that some people are looking at me and feeling grateful that they aren’t like me and fearful that they could be.

I am a walking cautionary tale.

When I raised this concern with John Birmingham on Twitter, his response was

Maybe it’s not about you.

Obviously, his piece was about The Biggest Loser, a particular kind of “freakshow”. Me going to the shops to buy my bread and milk? Not so freakshowish, admittedly. But I am still there, I am still visible, I still jiggle, I still have a double chin, I still look fat enough to be a folk devil.

Fatshion bloggers sometimes find their images reblogged as thinspiration by people who are engaging in disordered eating and looking for fodder to increase their fears of becoming fat. People in public places like swimming pools snark and gossip about fat bodies around them and barely feel the need to disguise their disgust. A friend on Twitter, Jennifer Gearing, mentioned this afternoon that Birmingham’s article “reminds me of time stranger told his 5-6yo she didn’t want Maccas or she’d look like me.” That’s right, children, fear and pity that fatty over there, and thank your lucky stars it’s not you.

There are so many problems with taking that approach with children. (I shan’t list them all but, um, how about these: what if your child grows up fat? what if your child develops an eating disorder? what if your child becomes a rude and judgemental body-snarker?) One really big loser of a problem is that the fatty over there is a human being. The fatty on your television screen is a human being. Human beings have emotions and a need to be treated with respect. We also have diverse histories and reasons for being the sizes that we are; we have individual stories that you can’t read from just looking at us.

My fat body is not your punch line, it is not your entertainment, it is not your grotesque freakshow, it is not your life-lesson.

I happen to think that many kids could learn a thing or two from people like me, beyond a cautionary tale. But until our culture starts valuing people for what they have to give and not what they (apparently) have to lose, a lot of people will fail to see that.

And exploiting that failure to see human beings instead of “the obese” isn’t edgy and it isn’t even productive. It just hurts.

Thanks for your help, doctor.

One of my favourite elements of online activism (especially fat activism) is its ability to make the personal political. I love how fat activists are getting the message out there that we are not just headless fatties. We are real people, individuals, with diverse interests and values and needs and talents and stories.

For a couple of those stories, you might want to check out this wonderful short doco about young fat women. (Link to film, which contains some NSFW images from the Adipositivity Project, which is also probably NSFW incidentally!)

Here’s a story from me, about the realities of life as a fat person. To be honest I’ve been unsure about whether I want to share it because, well, trolls. But I think it’s important that we speak up about how grindingly difficult it can be to just be heard, as a fat person, and how trying to focus on Health At Every Size instead of embracing the commercial weight-loss industry is some kind of radical act (despite, really, it resembling so many kinds of common sense).

I’ve been having some (relatively minor but annoyingly persistent) health problems; it’s been difficult to find the best way to cope with these, especially given that they are exactly the sorts of things that doctors struggle to either take seriously or find the cause of. Without going into detail, I will say that they boil down to fatigue and are probably linked to metabolic problems related to my polycystic ovarian syndrome. The logical thing seemed to be to seek a referral to an endocrinologist.

I’ve written a little bit about how fat stigma can interfere with patients receiving sound health care. I’ve previously had a little experience of that (like the time a GP recommended Weight Watchers as a ‘treatment’ for post-natal depression). Yesterday the endocrinologist gave me the full stigma experience.

I want to be clear: Dr M was a pretty nice guy. He was friendly, he looked me in the eye, he didn’t say anything ‘mean’, he answered my questions, he wasn’t dismissive. Occasionally I hear people saying that fat people only complain about doctors because they don’t like being weighed (he weighed me, I was totally fine with that) or because they don’t like hearing hard truths. That’s really a mis-characterisation of why we complain about fat stigma in health-care settings. It is about so much more than hurt feelings (although, frankly, hurt feelings matter too, especially when a bad experience with one rude or dismissive doctor can be enough to keep an already socially stigmatised person from seeking health care when it is really important to do so).

What was most frustrating about my appointment with Dr. M wasn’t that he outwardly fat-shamed me (he didn’t) and it wasn’t even that ‘prescribed’ weight-loss (although I didn’t particularly appreciate that, given that I started with a spiel about how I wanted to focus on health, and not weight). What is most upsetting is that I paid this man $220 to spend half an hour talking to me about how I could get thinner when what I wanted was for him to listen to me and offer me solutions and alternatives that might actually do something about the underlying cause of my symptoms and which may actually make me, you know, healthier. And even if you believe, as Dr. M clearly does, that weight loss would make me healthier — even if I believed that — the fact would still remain that he didn’t listen to me, that he discounted almost all possible causes for my symptoms aside from one which is not qualified to diagnose himself and … fatness.

Make no mistake: I know that this only happened to me because I am fat. If I were a thin person and I walked through his door with the symptoms I described, he would have been forced to dig deeper. To ask me more questions, to hopefully come up with a wider range of options. Maybe run more tests.

Instead he saw a fat woman sitting in front of him, and I’m quite sure that he, seemingly decent chap that he was, thought that he was offering me wonderful advice and providing an answer to my ‘struggles’. Except that he wasn’t. This is the problem with the pervasiveness of fat stigma and the failure of some health professionals to treat patients as individuals with individual health needs, not as statistics in a ‘war on obesity.’

In case y’all are wondering, this is basically how the appointment actually went:

[After a brief chat about medical history and symptoms...during which, he didn't actually ask about my dietary habits or exercise levels.]

Dr. M: So, you’ve been struggling with your weight?

Me: Well, I wouldn’t really use the word ‘struggling’. I have gained weight, yes. I think that might be a symptom of some of the underlying issues I have.

Dr. M: Yes, definitely because [explains some likely hormonal causes for weight gain as shown by my blood test results etc.]

Me: Like I mentioned to begin with, I would just like to be healthy, rather than concentrating on weight. I’d like to have more energy and vitality, that’s my main concern at the moment.

Dr. M: Ok, that’s a sensible approach. So what have you been doing to try to lose weight?

Me: Well, as I said, I’m concentrating on health, not weight. I’m not actively trying to lose weight. I have recently increased my exercise by seeing a personal trainer again, and I’m making sure that I eat regularly to keep from having so many mood swings and energy dips.

Dr. M: Yes, sounds like you’re really on the right track. Well, here are some options for you, although I’m not pushing you into anything.

Me: Ok, sure.

Dr. M: You could try a meal replacement programme… [lists a few different commercial programmes and warns me that I'd still have to eat vegetables or I'd get constipated]

Me: Ok, well, as I said I’m really interested in health and vitality. I’m also concerned about the potential negative effects of yo-yo dieting so I tend to avoid ‘diets’.

Dr. M: Yes, fair enough. Well, another option is Reductil and those types of drugs [yes, he seriously did recommend a banned weight loss drug (which, prior to the TGA withdrawing approval, was shown to have limited effectiveness anyway) to someone who had already made it clear that weight loss was not a goal.]

Me: *incredulous stare*

Dr. M: Of course, your best bet for long-term benefits would be surgery. There is a surgical option called gastric banding, which, the latest ten year studies are showing, does offer the best long-term solution for weight loss.

Me: Ok. If I was concerned about weight loss I might want to talk more about that. At the moment though, I’m interested in finding out more about why I’m having these symptoms, and dealing with those.

Dr. M: Yes, well… allow me to refer you to another doctor who can investigate [X] possibility with you. [Explains]

Me: Sure, okay, that’s worth looking into, I’ll have that checked out. What about what [X] and [Y] test results say? Do you have any thoughts about that?

Dr. M: Well, you can try [X] drug. The big benefit to that is that it might reduce your appetite.

Me: Ok, well, that’s fine, but remember I mentioned that one of my symptoms, that I wanted to address, was reduced appetite and irregular appetite?

Dr. M: Oh, yes, that’s right. Well there are other benefits too. It may hold off the onset of diabetes.

Me: Well that sounds like a good benefit. But I thought you explained that I don’t show any signs of diabetes or even pre-diabetes. And I confirmed that I don’t have a family history of diabetes?

Dr. M: Yes, that’s right, you don’t have pre-diabetes. Yet.

Me: Sure, ok. Can you tell me what the other benefits are to taking that drug? Will it help with any of my symptoms? Because what I would like, why I’m here, is because I’d like to be healthy and have some more vitality…

Dr. M: Yes, that’s a sensible way to look at it. Well, how about you keep doing what you’re doing, and come back and see me in six months to reassess things?

Me: Thanks for your… help.

I reckon I need another new doctor. What do you think?

** NB. I have included more details about my personal health than I feel entirely comfortable about sharing publicly, but I needed to include them in order to illustrate my point. This doesn’t mean that I’m open to people offering diagnoses or cures, so please, don’t do that. If I want your opinion about my health status I will be sure to ask you for it. What you are most welcome to share in comments though, if you would like, are your experiences of fat stigma in health care or, if you can, happy stories about when doctors get it right. Sometimes it’s hard to remember that some of them really do!

Good morning, fat-shaming and mother-blaming

Check out this article on the website for Good Morning America. Apparently, parents are panicking so much about ZOMG OBESITY CRISIS BOOGA BOOGA that they are putting their infants on diets. Says the chair of the nutrition committee of the American Academy of Pediatrics:

I have seen parents putting their infant and 1 year old on diets because of history in one parent or another

and Dr Blair Hammond, another peadiatrician, laments

There’s some parents who are very pleased when their children are thin…A lot of fathers, even, they’re like, ‘Yes, my daughter’s thin,’ when the daughter’s like 5 or 6 months old. [this is pretty much the only part of the article that mentions male caregivers as having any influence on infant nutrition, by the way].

None of this surprises me in the least — I posted about the fact that fear of baby-fat and fat babies is an inevitable and dangerous by-product of obesity panic back in April.

What I want to point out here is the way that this issue is being framed. Parents (mostly mothers) are at risk of depriving their children because they are projecting their own body image fears onto them. Some extreme and disturbing examples are quoted and it is very clear that this ‘trend’ (if you can call it that, I hope it’s not truly an accurate description) is harmful and in many ways an example of parental vanity. Certainly in the quote above, fathers’ expectations of slimness are presented as problematic. And they are problematic, for sure! But, um, whose fault is all this weight scrutiny?

Is it really any wonder that in a weight-obsessed, fat-phobic world where thinness is almost universally equated with health and happiness in mainstream media and even by medical discourse, that parents are increasingly anxious about their infants’ weight? Is it any surprise that when plumpness in babies and children is no longer aligned with prosperity and good nutrition but actually seen as a sign of weakness, lower social class, ill-health and early death, that our previously-held beliefs about the healthy-glow of chubby baby cheeks and the squishy reassurance of roly-poly limbs have been replaced with fear?

I’d be angry and saddened by the actions of a mother who feeds her 7 month old water in order to keep his weight down, too. But the real culprit in that equation is clearly our weight-obsessed society, where disordered eating is normalised and adipose tissue pathologised.

You only need to check out the Good Morning America link itself to see what I mean — look at the titles for the other videos linked to this particular page. They are

• Overweight babies
• More than just baby fat
• Dangers of childhood obesity
• I fear for my obese kid’s self esteem

And these people are surprised that parents worry about weight gain in children? This is so disingenuous it seems like a joke, except that I’m not laughing.

(h/t to @FreeChildhood)

Privilege and the food police: a rant and some tasty links

I really can’t abide smug foodies.

Want to eat organic cucumber salad on home-made sourdough followed by sheeps-milk yoghurt churned at your local organic farm, laced with honey from your uncle the bee-keeper, wrapped in recycled wax paper from the co-op store in your suburb? Go right ahead. Sounds fabulous.

But if you think, for one second, that everyone should eat like this way, it’s easy and if only they did there wouldn’t be an obesity crisis booga booga and we’d save all the animals and other people are just so selfish/lazy/greedy/stupid and did you see that thing about the McDonald’s burger that lasted for six months without going mouldy how can people eat that shit? then you need a serious privilege check.

A lot of people seem to be able to easily grasp the notion that foods don’t have a moral value based upon their calorie content: plenty of  (though clearly not all) people are okay with the idea that chocolate cake is not actually a sin waiting to happen, and that it’s really okay to eat some if you feel like it, even if you don’t plan to spend the requisite hours on the treadmill right afterwards. But I’ve encountered many people lately who are still convinced that there is another kind of moral value tied up with food. These people don’t necessarily think that fast food is immoral because of its high fat content and ability to ‘break a diet’ but because it is cheap, or chemical-laden, or a product of questionable farming and business practices, or laced with trans fats, or replete with too many food miles, or produced by an industry that treats workers poorly, or devoid of wholegrains, or simply the opposite of quinoa porridge sweetened with homemade organic apple puree. These are the people who seem to assume that ‘obesity’, or diabetes, or social ills, could all be cured if we simply educated folk on how to grow and cook their own food, if we could simply revert to some mythical time in the past where food was more natural and people were (mythically – the rising life expectancy would say otherwise) healthier.

There is a lot to say for the slow food, local food, organic food movements. Farmers’ markets are great. Fresh, local produce tastes wonderful and supports the local economy. Home cooked is often best. I grew up eating home-grown organic vegetables served with meat raised and butchered at home, with home-baked desserts and home-made preserves. My step-mum even baked all of her own bread (and still does). We had our own hens for eggs. All of which points to the fact that I am not here to plead the case for processed-over-’natural’ (although, to be frank, all that ‘natural’ food, fresh air and exercise didn’t innoculate my family against illness or fatness like food evangelists would have us believe it always does)!

Living that way wasn’t as idyllic as it might sound: we were never hungry, but good food was one of the only luxuries we enjoyed and it cost a huge amount of labour and relied on skills that only a minority now possess. It was also a product of rural life — the vast majority of Australians live in urban environments where chicken coops are not the norm.

Many Australians also live in poverty. It is only a privileged minority who don’t face systemic barriers to the foodie lifestyle. Indeed, some — far more than should be acceptable in ‘the lucky country’ — lack even basic food security. There is no excuse for smugness whilst chewing on organic sourdough when the fact is that the time and money to pay mind to anything other than your own need for calories when making food choices is an extraordinary privilege.

I think those of us who can, probably should, spend some time thinking about the impact that our food choices have not only our health but on our community and our environment. But that can’t happen at the expense of awareness that exercising choice in that way is not a privilege shared by all. Unless systemic barriers to ‘better’ (healthier, more sustainable, more ethical) food choices are removed for the majority, being a ‘foodie’ will remain an elite pursuit and the ready availability of highly processed, high-calorie foods will continue to sustain people who would otherwise go hungry.

Please take some time to read this interesting piece from Newsweek about the link between food choices and social class – it’s US-centric but much of it also applies here.

And because when we shop (and when we are smug) it’s not just about food – this great post at Raising My Boychick about ethical shopping and privilege is also a must-read.

Money is also not the only barrier to making ‘foodie approved’ choices — see these two posts about disability and food: Before you criticise the food choices of others by s.e. smith and food. by anna at FWD. I haven’t even touched on the vegan movement here but there is a lot of privilege wrapped up in those ideals too, including ableism; genderbitch deconstructs some of it here. (h/t Definatalie)

Finally, this is one of my favourite posts by The Fat Nutritionist, also worthy of your time: If only poor people understood nutrition!

On training

My friend Samantha and I clearly have great minds, since we think alike: we’ve both engaged personal trainers in the last few days. You might want to check out her post about it — really interesting to see how a weight-loss focused trainer deals with a client with different goals.

I’ve been wanting to get a new trainer for quite some time now, but it really is an extravagance, budgetarily speaking, that has been difficult to justify. Until lately when my lack of energy has been such that it strongly impacts on the quality of life for the whole family and doing something about that seems more like a necessity than a luxury. I don’t know if greater fitness will be the whole answer (it’s unlikely, actually, given that I have some health stuff going on) but it’s not going to hurt. Feeling strong again would be super. So would enjoying the gym again. I know not everyone is a ‘gym person’ and I was mightily surprised to discover that I actually am, but it really does function as a good release and escape for me. Throughout my childhood and teen years I was pushed into sports and whilst I do think there are benefits to encouraging children (especially girls) to play team sports, they just weren’t for me. I grew up thinking that I hated exercise — the truth was I just loathed barking PE teachers, enforced competition, balls flying at my head and having to wear stupid netball skirts. At the gym I don’t have to talk to anyone, I don’t have to compete with anyone (not even myself, unless I want to) and I sure as hell don’t have to wear anything I’m not comfortable in. Revelation! Lately, though, the gym has been a struggle. I’m tired so I don’t feel like doing much. I’m busy so I keep forgetting to make creche bookings. I’m bored, so I don’t bother with a programme and then don’t feel I’m making any progress.

Enter my trainer.

She’s the fourth personal trainer I’ve worked with. All of my trainers have been quite different in their approach. I’ve always mentioned in the first session that weight loss wasn’t my goal (even years before I had discovered the fat acceptance movement I saw exercise as an end in itself). They all interpreted that information a little differently, though, I must say. (Thankfully, I don’t have any horrible recollections of shaming or nastiness from a trainer, but I’ve heard some stories!)

My session with L today was a little bit of getting-to-know you, so I’m not sure how she’ll structure a full session yet. I’m happy to say that thus far I’m really comfortable. Without specifically discussing Health At Every Size I can’t tell you what her thoughts are on a health-centred rather than weight-loss approach.  But she did give me some clues:

• Her first question was about my goals. I said that I simply want to feel strong, and have more energy. She accepted those as worthy goals right away and didn’t try to suggest anything different.
• She didn’t comment on my weight, or assume (out loud at least) that I am trying to lose weight.
• When I mentioned that I’ve been fatigued lately, she asked me if I thought I was eating enough. I was waiting for some moralising (make sure you don’t eat junk/forget the sugar etc.) but it didn’t come. She simply suggested, when I admitted that I don’t always eat as well or as often as I should between breakfast and dinner, that I eat more food during the day. I do feel better in the afternoons if I remember to eat an apple or something for morning tea and follow it up with a decent amount of lunch. It seems like common sense but as a fat woman — now a ‘morbidly obese’ woman — I’m not used to people telling me to eat more. Honestly, I felt really great about the way she didn’t just assume that I eat too much food because all fatties eat too much food. It was a reminder of how much my guard is up all the time, waiting for the fat-shaming, and how refreshing it is not to have brace against it.
• I survived the session really well. Some trainers assume I can’t do anything well because I don’t look like a gym bunny. It’s nice when they let me show them what I can do before judging me.

Erin, the trainer I had previously worked with for the longest period, was also happy not to focus on weight (until I started dieting and bringing it up myself). Working with Erin was a powerful experience for me. She pushed me very hard, as hard as she could without being cruel (she was no Michelle Bridges!) She helped me to learn that my body can impress and surprise me, that I am not ‘bad at exercise’ and I in fact developed pretty good technique. I distinctly remember using the leg press one day and looking down at my thighs and realising, with quite a jolt, that they had shrunk. I’d never thought of my legs as fat but suddenly they were significantly less fat and that made their previous size loom large. Erin moved overseas when I was at my lowest weight, with my thinnest thighs, and I remember thinking at the time that I was going to stay that way because of all I’d learned from her.

Of course, my thighs got their fat back, and then some. Bean was born and I had a long break from the gym and struggled to go back. And for a while, I felt a bit sad that I’d unlearned the valuable things that Erin had taught me and lost the confidence she’d helped me to find. But lately I’ve realised that isn’t the case. I still know that my body is strong. I still know that with effort, I can be fit. I still know that although I avoided it for so much of my life, I actually like to sweat and feel my muscles burning, if I let myself be taken over by it all. I still know that what PE and sports coaches and life taught me about my big ungainly useless body is not actually the truth.

I want to trust my body again. I’m hopeful that my new trainer can help me out with that.

On bullying

A few weeks back, Natalie from Definatalie made it known via twitter that she was being bullied on Facebook. Someone had taken a photograph of her from another site and posted it to a hateful Facebook group in order to shame and ridicule her. Natalie took it in her stride beautifully (read her graceful response to the Facebook group and the experience here), I’m happy to say. But me? It made me a little afraid.

I think we accept now that bullying is not confined to school grounds, and also that the bullying that goes on in childhood can be far more serious than the old narratives about character building would suggest. I believe that the ugliest aspects of humanity dwell in bullying behaviour: bullies dehumanise and objectify, they use the power of many against one or a few, and they take pleasure in the destruction they wreak. This would be hyperbole if people were not being bullied to death, but they are.

I’m not a school student, and I don’t really have a workplace, so one would think my vulnerability to bullying, in the sense that we think of it traditionally, would be limited. Perhaps it is. I’ve been bullied online more than once though, and the reality is that I will be again, because I write things that some people don’t like to hear, because I post photos of myself sometimes, because I participate in online communities where there are, like everywhere else, power-plays and popularity contests.

And, as I’ve just said, bullying scares the hell out of me. Bullying is triggering for me.

Bullying had me rehearsing suicide notes at nine years of age. Bullying gave me bruises, scars, knocked me to the ground and winded me. Bullying made me vulnerable to other forms of victimisation, about which I don’t wish to speak. Bullying made me try so hard to be liked that I was, for a time, virtually unlikeable. Bullying made me strong and it made me an advocate, yes, but at what cost?

I once left a job because I was bullied there. The bullying wasn’t so terrible, the bullies had only transitory and limited power, and I had support. But the extent to which I felt disempowered for even a few moments horrified me and sent me spiralling into anxiety, insomnia and depression. I was humiliated by my inability to ‘take it in my stride’ as much as I was angry at the original treatment. With hindsight, I can see that what appeared to be an extreme reaction was perfectly natural from someone who’d just been so strongly triggered: after the core incident, I was shaking, pale, in shock, having flashbacks. I could not work. What my colleagues saw was someone who’d had a very bad day and was unable to overcome that without help. What they were really seeing was someone who had been bullied so viciously in the past that her wellbeing was at risk from comparatively minor incidents.

Bullying is the most rapidly expanding workplace health problem, especially in schools – that is, it affects teachers as well as students in devastating ways. It’s also rife online. The tragedy of the latter situation is that online spaces are commonly used by groups of people – perhaps victims of trauma or those commonly subjected to prejudice – who wish to carve out a ‘safe space’ for themselves. And in many ways, online interactions can supply an enormous amount of social support to those, and all, people. We alternatively scoff and ruminate about the amount of time young people spend online but the fact is, there is a lot to love about the access they now have to vital information and crisis resources. Loneliness and isolation can be more easily combatted when there are more ways to let others in.

But our computers and our iPhones let the bullies in, too.

This doesn’t have to be only bad news, because with this growing awareness that bullying is more than a few taunts in the playground, comes growing responsibility. Bystanders have enormous power, and little excuse not to exercise it. When children are bullied in schools, the majority of us have no chance to act because we are simply not there. But we are online. We are on Facebook, and we can (and do) lobby for offensive groups to be closed down and call bullying when we see it. In comment threads and other online spaces, we can intervene (even with a degree of anonymity) to show bullies that we’re onto them. We can be blatantly intolerant of those who seek to attack and victimise others, or who use undermining and silencing tactics. And in our everyday interactions we can show integrity, courtesy and openness: we can refrain from committing the violence of harsh words or social exclusion.

Maybe these are small things, but they are something, and nothing is not an option.

Baby’s got fat

In the aftermath of this Mama Mia post and my response, it has occurred to me that there is one group of people whose weight definitely is regularly scrutinised. This scrutiny is taken for granted and largely passes without comment, although the consequences can potentially be very damaging. But because this group is voiceless and because their ability to maintain good health is entirely dependent on other people, any potential damage is glossed over and the virtues of this practice exaggerated.

I am speaking, of course, of infants and toddlers.

Weighing babies is clearly a simple and often effective way of judging general health: a baby who is putting on weight regularly is growing well, and therefore eating well, and is probably doing just what a baby needs to do. On the other hand, a baby that is losing weight over a period of time or not growing, may not be feeding well or may be otherwise ill. Similarly, measuring the height and weight of toddlers is a general way of checking that growth is occurring, and keeping track of these measurements should alert parents or health professionals to sudden weight fluctuations which may indicate a problem. Using a growth chart does make a lot of sense. It’s not a practice which is necessarily on a par with weighing older children and adolescents. In most cases, where health professionals are sensible, they will allow for the wide range of normal differences in infant growth patterns and will also never diagnose a problem (with feeding or anything else) from looking at a growth chart alone.

The problem is, common sense is not always engaged when it comes to the question of weight. And anecdotally, it seems that mass panic about obesity is fuelling a rise in the level of scrutiny of babies and toddlers who weigh in at the upper end of the scale.*

I personally know at least four babies and toddlers who have been labelled as ‘obese’ or at ‘risk of obesity’ by health professionals and whose parents have been admonished for their child’s excessive growth. (And this is not counting the many other stories I’ve heard about ‘friends of friends’ or read about online.) Of those four babies and toddlers, not one of them was unhealthy, suffering from recurrent illnesses or developing any slower than expected. All of them have caring parents who, like the vast majority of parents, take their responsibility to provide good nutrition and a healthy environment very seriously. And yet, because of a number, these children have already been labelled and judged to be at risk of poor health. By extension, their parents have faced judgement. As the new TV promo for the show Politically Incorrect Parenting declares, ‘If you have a chubby kid, it’s your fault!‘

Luckily, these particular four have parents who possess education and also common sense — enough common sense to know that a healthy, exclusively-breastfed 6 month old can’t be dangerously obese; that a chubby 8 month old of non-white South African heritage with parents who were both large babies is meant to be chubby; that a tall and solid toddler with very tall parents and a varied diet full of fresh foods can be perfectly healthy as well as off-the-chart heavy; and that a four month old baby with chubbalicious rolls who is thriving and alert is not ‘at risk of future early death’ because of his roly-poly body, no matter how many times a GP says it. Diagnosing a healthy baby with normal baby eating habits and activity levels as dangerously fat borders on the ridiculous — not only because a baby’s body shape is so very transient but because this reflects an entirely new fear. It’s logical that babies and toddlers who are strong and heavy are best set up to weather any illnesses or food shortages and therefore in times past (and currently in many other places around the world) they would be considered robustly healthy. Beautiful. Something to be celebrated.

Not all babies and toddlers ‘diagnosed’ as ‘obese’ are as lucky as the ones I know. Some of them have breastfeeds or bottle feeds cut back on the advice of doctors.**  Some of them have foods restricted, or ‘treats’ like full-fat yoghurt removed from their diets (and replaced with lower-fat, higher-additive versions), or portion controls regulated externally rather than through their own hunger cues (a sure-fire way to increase the likelihood that they will put on more weight as adults.) Some of them are told they can’t have foods that are ‘fattening’, or they have their ‘excess’ weight talked about in their prescence, or are given the message that they aren’t as healthy as their peers. Don’t think a two year old isn’t already forming an opinion of her body’s acceptability, because s/he is quite capable of doing so.

And as Ellyn Satter warns

Research shows that children who are labeled overweight or obese feel flawed in every way–not smart, not physically capable and not worthy. Parents who fear obesity hesitate to gratify their child’s hunger for fear s/he will get fat. Such labeling is not only counterproductive, it is unnecessary. [my emphasis]

So, what is driving this labelling and extra scrutiny of those who weigh in on the upper end of the weight-for-height charts?

Studies like this one by the University of Texas reinforce that obesity is ‘linked to serious health problems’, without any reference to the fact that such a causal link has not been proven, even where a correlation is apparent.*** This particular study claims to prove that obesity at six months is a predictor of obesity at two years and therefore (although it doesn’t explain how this leap is made) obesity later in life.

Babies grow at different rates. Babies have varying amounts of ‘puppy fat’. Babies who are large and solid almost invariably seem to have at least one parent who is also large and solid. And, what a surprise, such babies tend to continue their growth pattern throughout toddlerhood and childhood to be, um, large and solid! Is it so revolutionary to discover that a baby who is heavy at six months is also heavy at two? If, in fact, a baby’s normal weight gain had slowed so much as to plateau, this may be interpreted as cause for concern. Unless that baby is heavy. With a fat mother. In which case, plateauing off is apparently cause for celebration.

The press release for this particular study is quite chilling. It states that the value of these findings is great, because

pediatricians confronting infant obesity can recommend a number of measures that other research has shown are linked to healthy weight, measures that should be particularly effective because babies’ mothers have much more control over their diets than mothers of older children do.

Aside from the obvious gender bias there (of course, fathers don’t need to be shamed for the size of their children, or pay any mind to household nutrition!), that passage chills me. Because what it is suggesting is that taking control is a good thing. The truth is, where it comes to eating – even for very young infants – the more control an individual has over her/his intake in relation to hunger and satiety the better for health and yes, for weight. It’s a good thing if parents make conscientious choices about what food is offered to infants and toddlers (including choosing breastfeeding where possible) but exerting control over how much food is eaten is at best counter-productive, at worst disastrous.

Clearly, this kind of research and the way it is often taken up by the media raises more questions than it answers. What would be the net result of a peadiatrician’s interference with the eating habits of an an otherwise healthy six month old in the name of ‘obesity prevention’? How would that interference affect a mother’s confidence in her ability to care for her child? How would such intervention affect a child’s perception of hunger, satiety, and food security, possibly to the detriment of long-term normal eating? And importantly, how would a family with very little resources address this ‘problem’? Who is going to remove systemic barriers for mothers with ‘obese’ babies so that they can be helped (if required) rather than just shamed and blamed?

This is a Texan study but the underlying attitudes are international. Anecdotally, I know that some parents of Australian children who present as heavy for their height at their 2 year old check are being advised to ‘not allow the child to gain any weight’ for the rest of the year, or some other arbitrary time frame. In other words, to somehow magically stop the child from growing. Presumably, health nurses giving this advice have swallowed two lies: the first being that parents can control their child’s growth and the second that it is healthy to restrict the food intake of a two year old in order to ‘make them grow taller but not fatter’.

This is alarming. This is a world where a baby was starved for fear of fat, where another baby was denied health insurance for being obese and where younger and younger children are actively dieting and developing eating disorders. In such a world, we need medical personnel to be voices of reason, not to function as mouthpieces for the diet industry.

This is no more apparent than in the lives of some of our most vulnerable people. Babies depend on our common sense. They depend on us to nourish their bodies, and to give them unconditional love. Yet we’re careening closer to ‘Baby’s First Diet’ and this fat mother wants to know when the absurdity is going to stop.

• My Scales of Injustice piece has been cross-posted at Melinda Tankard Reist’s blog, along with another personal story about the long-term effects of scrutinising a growing girl’s weight. It’s a powerful account, well worth your time.

* I’ve been on both ends of this, as Bean was a very slim baby and is a solidly built toddler. I know first hand that some health nurses and doctors are so busy looking at the numbers that they don’t pay much attention to other health indicators in the child. Happily, not all of them are this way!

** In the case of breastfeeding, this can have a detrimental effect on milk supply and cause the end of a healthy breastfeeding relationship. Even with bottle-feeding, this might mean a hungrier and more unsettled infant and also set up early feelings of food insecurity which contribute to disordered eating.

*** A full review of the weight/health relationship is beyond the scope of this blog! But it’s well known that some illnesses seem to be closely aligned to a lack of exercise or other behaviours, but not simply to weight. It is also clear that some of the ailments often attributed to obesity – like hypertension – do show a causal link to fat-related factors like dieting far more clearly than they ever have shown to fat itself. I think it’s safe to assume that diagnosing someone as obese before they can even walk could set them up for worse long term health outcomes.

Scales of injustice

Now that I donate blood regularly, I am weighed a few times a year. This is the most frequently I have stood on scales in recent memory. It’s been interesting, to me, to note in numbers how my weight has altered (mostly increased) during this period of post-partum body adjustments, depression, medication and other health events. The number on the scale doesn’t mean very much: it is a number. It would seem very high to some, but then, I know that my dense body is heavy even when not particularly fat. So I don’t fret. But I can’t share that number with you here, as much as I would like to have that kind of fearless candour. It is still too early in my fat acceptance journey, perhaps. Or maybe it’s because I know what numbers mean to other people.

I know what numbers can do.

Like many people, high school Physical Education classes were not funtimes for me. I was labelled as unfit and unco-ordinated very early on in my school career and thereafter it didn’t seem to matter what I did. If I tried hard to improve my fitness, I was laughed at (mostly by other students: one notable time, by a teacher.) If I dawdled and wheezed, I simply confirmed the stereotype. If I listened too hard, I heard the slurs whispered behind my back as teams were picked or we lined up at the swimming pool, bodies exposed to scrutiny. Sometimes the hostility was overt.

A few times, we were weighed in class and those weights were listed publicly. I remember the trembling shame, and the flooding relief to not be heaviest. I remember the knowledge that I would never be popular until I was thin. But my body doesn’t do thin. It didn’t do acceptable in those formative years any more than it does now.

Kate Moss was it-girl of the moment (how little things change!) and my body, my unwaif-like body, was never going to make it onto the ‘hot’ list. And because I am obstinate and strong, I decided to just bide my time until I could choose to be around less-judgemental peers. But that wasn’t an option for everyone – fad diets were a weekly event for some of the students at my boarding school and I sporadically joined in. I remember telling a friend, mid-diet, that she was perfect how she was, and being laughed at. I was a fat girl, a lost cause, what would I know?

I feel like I need to say here that I wasn’t that fat. I wore straight sizes. I was active. I may have been in the D grade team, but I played sport. But it was apparent to me that in the eyes of my adolescent peers, and also my family, my body was outsized, unattractive and out of control.

My stepmother wasn’t generally big on body shaming but she did worry about my weight. Inconsistency raised me: my parents encouraged me to restrict portions one day, indulge the next. They loved me with food because physical and verbal affection were generally out of their range. And they singled me out from my siblings by making me do extra exercise. A lowlight was when my stepmum publicly informed a few other mothers from my primary school that I had graduated up to adult sizing (something that frequently happens quite suddenly to girls about to hit puberty). They were audibly shocked, no doubt thinking, gosh, I’m glad that hasn’t happened to my daughter yet. It’s twenty years later but their judgement still smarts.

It wasn’t that I didn’t try to control my body. I documented my first serious attempt at a diet in a notebook. I drew up tables and stuck them on the fridge, indicating which days I would be allowed to have dessert. I was eight years old.

Eight is the same age of the daughter of one of the commenters on this post by Mia Freedman about weighing children, and about the age at which most girls are beginning to be aware of their weight.  In her post, Freedman asks: “We’re obviously keen not to give our kids any complexes about their weight but does that mean turning a blind eye to weight gain for fear we might say the wrong thing?” Apparently, Freedman accepts the premise that the growth of a child’s or adolescent’s body requires commentary, and that such commentary could actually control that growth.*

The problem with these types of arguments about weighing children to ‘fight childhood obesity’ is that they show little understanding of how diet–weight–health interact: that is, in a far more complex and non-linear way than is popularly believed. A number on a scale doesn’t shout to your body: hey, stop growing as you wish to grow (largely due to genetic factors) and fit neatly onto this chart, dammit! But it may say to the adults around a child: start putting undue scrutiny on this child’s appetite, start singling her/him out for ‘special’ exercise or food, start making her/him feel less than for not looking the right way.

What infuriates me most about the idea of frequently weighing children and adolescents – or publicly weighing them – to keep them ‘on track’, is that it singles out the fat kids, and the solid kids, and even the underweight kids. It perpetuates the disproven notion that weight and health are intrinsically linked. I’m all for improving the health of young people. I think reducing our reliance on processed foods and increasing people’s activity levels are admirable goals. But when you aim these goals almost solely at vulnerable people who are already singled out by their appearance and who are already at risk of low self esteem, you do them a huge disservice. And actually you do everyone a disservice. Because thin children need nourishing foods and plenty of fun exercise in the fresh air, too.

More than that, we all need to stop buying into the lie that a single aesthetic ideal is a virtue to strive for, or the answer to everything. It has taken many years to overcome the damage done in PE classes, but finally I don’t much care what the scales tell me. They can measure how much the fluids and tissues of my body weigh. They do not know if I am strong or healthy. They also do not know my worth.

Concerned parents, teachers, public health authorities and popular culture commentators with successful blogs take note: We must not make the mistake of letting some children think that they are worth less — worthless — because they weigh more. Numbers on a scale are not nuanced, they are not intelligent, they are not loving, they do not listen. They are no substitute for real information about health and wellbeing and they are not a parenting tool. Our children deserve so much more.

—

* N.B. It is common sense that where sudden weight gain is large or coinciding with other symptoms (other than puberty) then that is a good reason for a health check with a good GP, and subsequent discussion. But for a typical increase in chubbiness? For heaven’s sake, children ought to be allowed to just be happy in their bodies. Bombardment with fat-shaming media is never far away so parents aren’t actually required to join in. Besides, shaming children into restricted eating and/or exercising will not make them lose weight – unless it pushes them to starve themselves. For more information on how children can regulate their own food intake and body size, Ellyn Satter is a good starting point.

Fat Goddesses

At the gym this morning a woman I used to chat to after our cycle classes jumped on the treadmill next to me. We hadn’t spoken in a while, but we have our fatness in common so it was easy to find things to talk about. Especially since I was wearing my Fat Goddess t-shirt.

My gym friend (I’ll call her Mary), was pretty awed by it. She pointed to her own colourful t-shirt and explained it had been purchased on her recent trip to Thailand, in a special plus-sized store, where they made her pay extra for ‘more material’ and followed it up with a loud statement about how freakishly huge she was. (And yes, I know extra material probably does cost more – but that is not the issue at hand.) Mary also had some other interesting experiences on holiday. Like the time she walked into a massage place and asked their prices, only to be told that since she was so big, they would charge her double. And then they laughed at her, in front of the other, slimmer, tourists. Now, I’ve been to Thailand for a holiday too and I never had these experiences. Mary was unlucky, by the sound of things – I’m certainly not saying that Thai people are all unfriendly or fat-phobic. But perhaps what happened here is that cultural and language differences allowed for the kind of things that many people think all the time about fat people but just don’t say out loud.  (Which is something to think about, if you’re walking around with thin privilege).

Mary was diagnosed with type 2 diabetes last year, but she hasn’t been to the doctor in six months. She knows that this is probably unwise, but the last time she went to the doctor she felt down for weeks. She’d bounced into the surgery, saying how she felt energised by the progress she’d made in our spin class, and that although the strict dietary changes recommended had been difficult to implement, she’d been making some healthful choices. Her doctor’s response? Come back and tell me you’re doing well when you’ve lost thirty kilograms. No recognition of her health-improving efforts, no checking of test results before the admonishments. Amazing how so many doctors can tell your blood pressure, blood sugar levels and cholesterol just by looking at a number on a scale! The net result of this, for Mary, was some more weight gain after yet another failed attempt at a diet. And confirmation that she’s not good enough, that doctors won’t or can’t help her because she’s too fat to deserve it. For her, this means a lot of days where she can’t make it to the gym because just getting out and about, amongst bodies different to hers, makes her feel painfully ashamed.

I’ve encouraged Mary to try another doctor but you know what, I get why she hasn’t. Because this story? It happens all the fucking time. I can’t even begin to tell you how angry it makes me.

It happened to me last week. Because I am fat, my doctor is reluctant to prescribe medication which may cause further weight gain. (It’s been a year since this particular doctor took my blood pressure or ran any blood tests so how he knows that weight gain will actually harm me more than remaining unmedicated is, again, anyone’s guess.) Because I am fat, my doctor admitted that he’d assumed my daughter was conceived using reproductive technology and birthed via c-section (the truth is that she was conceived the ordinary way, and during my pregnancy I had no complications and delivered a lustily crying babe without intervention or complication). Because I am fat, my doctor thinks that a good treatment for my depression would be Weight Watchers, even though he knows that my depression began long before I was fat. (Presumably, he also doesn’t know that no diet, exercise or ‘lifestyle’ program has ever been proven to result in long-term weight loss in more than a very small percentage of people. The ‘cure for fatness’ just doesn’t currently exist, but they keep forgetting to send out that memo). My doctor, who I thought was a good and sympathetic doctor, said all of these things to me without once asking me what eating habits are actually like and what my activity levels are.

Naturally I felt deflated, angry, let-down by this treatment.

But I’ll get over it. I can find another doctor. I have the courage of my convictions and a lot of support. And I know that despite what this doctor – or anyone – may think, I am a person who cares about my health (even if I don’t always get it right). But for every fatty like me, there are many others who still feel cowed by the world telling them they are worthless. There are many others who don’t have a supportive partner or the time and inclination to read about Health At Every Size or to stumble into the affirming Fatosphere. There are many others, like Mary, who would rather risk exacerbating a health condition than be shamed and dismissed by just one more person who is supposed to be helping them. Because fat-prejudice is real and it is demoralising and it affects people’s lives in sometimes debilitating ways  – and it makes people sick.

This whole fatties-united conversation I had this morning happened whilst Mary and I were on the treadmill, and then the stepper, and then the cross-trainer.  I worked hard because anger was fuelling me. Anger that Mary’s mother, like my own, had told her she was disgusting and made fun of her body before she even hit puberty (and well before she was actually fat). Anger that Mary’s child, like mine, had already been subjected to a running commentary on his weight.  Angry that until that moment when another fat woman stood beside me, I had been unable to overcome my self-consciousness about wearing my Fat Goddess t-shirt.

But another fat woman did stand beside me. And another one was on my the little TV screen on my treadmill, and another in the magazine I thumbed while I had a coffee afterwards.

We are everywhere, and we deserve good and unbiased medical care, and we deserve to be treated as the diverse and worthy human beings that we are. The Fat Goddess, she demands it!