Friday, July 27, 2007

Social Networks and Transmission of The Fat

I edit for a scientific journal, and I've been doing it for over 11 years (see previous entry). I can pick apart epidemiological studies with the best of them, so I pulled up the New England Journal of Medicine article about how social networks facilitate the spread of obesity to see how the authors reached this conclusion.

(Note: that link is to the full-text version, so anyone can read the whole damn article themselves.)

The article tells us nothing. I mean that. NOTHING.

The only data in the article tell us this: friends of fat people have a greater tendency to become fat themselves than do the friends of thin people. It doesn't tell us WHY. Essentially, the article says, "Look, here's a connection!" That's normally the starting point for a study. Scientist sees a connection, and then tries to figure out what causes the connection. "Figure out," in a scientific setting, does NOT mean "guess." It does not mean "assume." It means "generate reproducible facts and data."

This article did NOT generate reproducible facts and data to explain this connection. Basically, the upshot of the entire article is that the authors think that, merely by being fat, fat people make their friends believe it's okay to be fat. I mean, seriously. Unless there's a significant portion of the article not present on NEJM's Web site, that's the only conclusion the article makes.

That's NOT evidence; it's merely reporting of a correlation. CORRELATION IS NOT CAUSATION. And I know that NEJM knows damn well that that's so.

And it pisses me off mightily that the mainstream media grabbed this utterly specious piece of crap and ran with it, just to fan the flames of fat hatred. That's just WEAK.

Thursday, July 26, 2007

"Boss? I can't come in to work today. Yeah, I've got The Fat, and I don't want everyone to catch it...."

What? Isn't that the next logical step from the news that OMG fat is contagious!!!?

I have, for the record, worked at the same job for over 11 years, and of the people who have also worked here for those 11 years, none of them have caught The Fat from me. A couple actually have lost weight, to what they say is their "true weight," and since they haven't gained it back, either that IS their natural weight, or they've been exercising/starving very, VERY hard for the past few years.

My boyfriend is a lean guy, with a 30-inch waist and corresponding lean measurements all over. We've been together for over a year, and he hasn't caught The Fat from me, despite the fact that he eats enough ice cream to ensure that neither Ben nor Jerry will ever have to worry about going broke.

To echo what the eminently wise Kate Harding says here, my not-fat friends from high school are still not fat. My not-fat friends from college are still not fat. My not-fat co-workers and assorted friends have stayed not-fat despite knowing me, sharing meals with me, and breathing my fat air.

My fat co-workers and assorted friends were already fat when I met them and still are, for the most part, fat. This is despite many Weight Watchers cycles, low-carb evangelism, and the Spinning craze. I'm pretty damned sure that their fat has NOTHING to do with me.

Unless....I helped "make" (keep) them fat by having the attitude that it's OKAY to be whatever size your body naturally wants to be, even if that's what society calls "fat." Because it IS okay. And I want people to know I believe that.

If THAT'S contagious, well, then, call me Typhoid Teppy.

Tuesday, July 10, 2007

Panic

This is what panic feels like: a frenetic fluttery feeling at the base of my throat, all my nerves wound too tight — like I have to get out of my skin before I explode from being trapped in it, and the realization that I'm holding my breath.

Kind of like Martin Sheen in the hotel room at the beginning of Apocalypse Now.

This panic is from my increasing conviction that I have to de-criminalize foods, take away the moral connotations of ice cream and Cheetos, and let them back in my house. And make sure that I have quantities enough that I won't feel like they're about to be taken away because they're forbidden.

Whenever I buy ice cream, I eat it in 2 days. Not a pint, mind you — whatever that size is that Edy's/Dreyer's comes in. Two days. I do the same thing with cookies, with almonds, with peanut butter, with snacky treats of any sort (c.f., Cheetos).

And I start to eat them the first day or 2 after buying them. I can't let them just sit there until I actually want those specific foods. Here's an example: this past Saturday, I did my weekly grocery shopping, and one of the things I bought was Edy's chocolate-with-peanut-butter-cup ice cream. (This stuff? SO GOOD.) Saturday afternoon I made myself exactly the lunch/dinner I had been craving — a liverwurst sandwich with juicy ripe tomato, swiss cheese, and mayo. Man, was that good! As a side dish I had a bulgur-tomato-black bean-corn concoction I devised.

I was full, I was happy, I had eaten exactly what I wanted.

And 5 minutes later, while I was still (obviously) full, the savage pig animal part of my brain started chanting. "Hey, we have ice cream. There's ice cream in the freezer. We have ice cream. Let's have that ice cream! Now! Let's have that ice cream now! Ice cream NOW! Ice cream NOW! NOWNOWNOWNOW!!!!"

I managed to make the savage pig animal shut up, by talking over its litany. I was full, I was satisfied, I had eaten exactly what I wanted, and, whenever I *did* get around to wanting the ice cream — truly being hungry for specifically the ice cream — I would eat it. Triumph! I did not eat the ice cream, because I didn't want it.

Midnight-ish, I woke up, checked to make sure the BF was sound asleep, and went out to the kitchen, took the whole carton of ice cream to the couch, and ate my way through half of it.

I hadn't wanted the ice cream, specifically. But I had to had to had to HAD TO eat it. The savage pig animal gets the better of me in the middle of the night. I'm too sleep-addled to talk over its litany. So I eat. And eat and eat and eat.

The issue here isn't that I'm eating a "forbidden" food; it's that I'm eating something — anything — when I don't actually want it. And the issue is also that I still view any food as "forbidden." Because THAT is exactly what drives me to eat it, and eat it all, as fast as I can. Because if I don't eat it right now now NOW, maybe it'll be taken away. Because it's BAD.

I recognize all this. I understand, too, that identifying your disordered relationship with food and its whys and wherefores is a GOOD thing.

I still view foods as having moral connotations. Broccoli = virtuous, ice cream = SIN. That comes from years and years (and YEARS) of dieting. And the years of dieting created the mindset of constant deprivation, which makes me devour "forbidden" foods at the speed of light.

Which is why, now that I'm making a concerted effort to love my body exactly the way it is, and take care of myself by eating what my body needs to be well-nourished and by engaging in "exercise" activity that feels good and is fun, I'm also trying very hard to de-criminalize food. To make nothing forbidden. Cheetos might not be optimum nutrition, but I will crave and crave and crave them because I've told myself I can't have them. And when I cave in and do get them, I eat the whole bag.

Cheetos are neither good nor bad. But I can't make myself believe that, not really.

At least, not yet.

I read an essay in — I think — one of Geneen Roth's books about a little girl who was gaining weight and who had issues with foods that were deemed "forbidden" to her. The therapist (or it might have been Geneen Roth; I can't remember and I'm at work and not near my books) told the parents to buy pounds and pounds and pounds of M&Ms, because they were the little girl's favorite food. Buy enough M&Ms that they would not run out, take a pillowcase, fill it with M&Ms, and let the little girl have the pillowcase to carry around and eat M&Ms whenever she damn well pleased.

The parents were petrified that this would lead to the little girl gaining massive amounts of weight, but they did it anyway. And the little girl did eat huge amounts of M&Ms...for about a week (possibly less). And then the parents realized that the pillowcase — which still had M&Ms in it — was lying abandoned on the floor, and the little girl wasn't frantically eating them. Because she KNEW THEY WERE THERE if she wanted more.

Why didn't that work with me and the ice cream the other night?

Well, I seriously think that I need to buy 2, or even 3, cartons of ice cream at a time. That way I'll have visual evidence that I won't run out, that it'll be there if I want it.

And THAT, to go all the way back to the topic of this post, is why I'm gripped with panic. Because I utterly, utterly fear that if I have 3 cartons of ice cream in my freezer, I'll devour all 3 within 2 days. Which will lead to the dreaded F-A-T.

I know that I need to (1) trust myself to eat what I want, when (and IF) I truly want it, (2) realize that no food is forbidden, and (3) realize that the possibility of gaining weight is NOT something to dread.

I know if I can feed myself what my body needs — and wants, TRULY wants — and engage in fun, joyful physical activity on a regular basis, my body will settle at the weight it's supposed to be. I've been reading the archives at Good with Cheese, because she's been going through a similar process, and — most importantly, realizing that she's happier this way. Infinitely happier.

I want that. But getting there? Well, THAT scares the crap out of me, because I'm afraid it won't "work" for me. And I don't know how to make it through the panic.

Monday, July 09, 2007

Diane Rehm Misses by a Mile

I listen to NPR all morning at work, and the Diane Rehm show rarely fails to entertain/edify me. I particularly admire (and, okay, LOVE) the way she firmly smacks down guests who get belligerent and try to talk over other guests who have opposing viewpoints. She kicks ass.

However, she really let me down today. The first hour of her show today was about stress and obesity, specifically if/how stress can lead to accumulation of belly fat. Her guests were all university instructors, in the areas of: (1) Physiology and Biophysics; (2) Pharmacology, Toxicology, and Neuroscience; and (3) Psychiatry; #3 is ALSO the director of research of the UCSF Obesity Center.

Some of the program was interesting in a biochemistry sense; stress DOES make the body do really weird things. But some of it, sadly, was the same old crap about fat people: at the end of the first hour, Diane asked her guests, "Will we ever get to a point where everyone wants to be slim?"

Gee, Diane, we probably won't, because I know that, as a big fat fattie, I want to be fat. I love being the object of bigotry and derision and discrimination. Why, don't you know I wake up every morning and make the decision to KEEP BEING FAT? (Which is similar to a point that Kate Harding makes about how anti-fat bigots sound an awful lot like gay-bashers: being gay/fat is, apparently, a CHOICE. Uh, yeah. Talk to Matthew Shepard about that. Oh, wait — you can't.)

Diane Rehm is normally so incisive and scary smart. I admit I'm extremely disappointed that she got this so wrong.

Now, if you'll excuse me, I have to go KEEP BEING FAT.

Friday, July 06, 2007

Am I a Hypocrite?

I'm pretty sure that, yeah, I qualify as a hypocrite.

I read these amazing, kick-ass blogs by people like Kate Harding, The Rotund, and mo pie at Big Fat Deal (to name just a few), and they make me want to run down the street waving a fat acceptance banner. I want to spread the word that you can be fat and healthy. And beautiful, and smart, and kind, and powerful.

Hell, I jumped on the blog bandwagon so that I could talk more about fat and health and beauty.

But I'm a hypocrite, because I catch myself thinking, "Oh, if/when I do xyz, I'll lose weight....", probably 50 times a day.

You see, losing weight has been my number one life goal for probably 25 years of my 36 years on the planet. (Which is so fucking sad to see the numbers just staring back at me like that — a quarter of a century in which the size of my body has trumped every other concern, bar none.) I know that I'm far from the only person who can say that. I realize that the fat-hating that has been inculcated in me doesn't make me unique.

I started dieting when I was 11 or 12, because I was tall for my age and therefore larger than the other girls in my class. I wasn't fat. I wasn't even overweight by the weight/height charts of the 1980s. But I had the misfortune of reaching my maximum height by the time I was 13 or 14, which made me a beast next to my classmates who weren't finished growing.

I started dieting when I was 11 or 12 because my mom was a model before she met my dad, and she never "lost" her model's figure. She worked absurdly hard to keep that slender frame, actually, and put a very high value on attaining and maintaining thinness.

Of course, I'm built like my dad, rather than like my mom — she's 5' 9", flat-chested, and not prone to building muscle, even with hard work. I, on the other hand, am 5' 6", have always had a generous bosom, and I build muscle literally within days. She and I are built completely differently.

The problem is, her frame is the one our society values. So telling myself that I was just built differently didn't really help my outlook. I figured I'd just have to try as hard as I could to be as thin as my build would allow. (And, when I couldn't lose weight past a certain point even when I fasted, I can see now that that was all my body would allow.) And my mom encouraged my pursuit of weight-loss, instead of promoting body acceptance. But then, how could she promote accepting a heavy body, when all her energies went into preventing her own body from gaining even an ounce?

(I have friends who talk about their overweight mothers, and I wonder what it would have been like to grow up with a female role model whose physical shape was one that wasn't literally impossible for me to achieve. How different would I be now?)

This is the part of the post where someone will tell me I'm blaming my fat on my mother. And I did do that, for a long time. Face it, parents lay down the psychological foundation — good AND bad — for their children. Growing up with a mother who valued thinness did affect how I viewed — and still view — my never-thin body.

But I'm an adult, and I'm responsible for my own well-being now, both psychological and physical. My mom may have laid the foundation, but (to continue the metaphor), I can build something new over it. Or, hell, I can just move somewhere else, where I can lay my own damn foundation. It's not a perfect metaphor, but I think my point is clear: I don't blame anyone for my fat these days.

....except I still blame me. Which brings me back to the subject of this post, which is that I feel like a hypocrite for promoting fat acceptance when I still think about things in terms of weight loss or gain. When I think that, if only I weren't so lazy, if I walked on the treadmill for an hour a day, I'd lose weight.

Yeah, that's blaming myself. And demonstrates a mindset that preaches fat acceptance while still hoping to lose weight. Blaming AND hypocrisy.

But I want to get to a point where I accept my fat self exactly as I am, and stop viewing things in terms of how they'll impact my weight. I watched Joy Nash's amazing Fat Rant for the first time tonight, and I so so SO want to be that self-assured and self-accepting.

I'm not there yet. Not even close. But I'm trying very hard to get there. And I hope that counts for something.

Tuesday, July 03, 2007

(Sort of) Inaugural Post

I created this blog a while ago, with the idea that I had Deep And Important Thoughts that the world should know. But my intrinsic laziness, combined with the idea that there are already so many bloggers out there who are talking about the same Deep And Important Thoughts, led to me abandoning the idea after a few posts.

(This kind of an introduction isn't going to make people inclined to read me, I realize. But I believe in giving fair warning, so consider this my own caveat lector.)

I've been reading a lot lately about weight, and weight-vs.-health, and fat acceptance, and the whack-ass things that doctors/the government/other talking heads have been saying about being overweight. As in, "Don't you know being fat will KILL YOU OH MY GOD?!?!?" And, you know, I'm a fat chick who's tired of being treated like a leper/puppy molester/dimwit just because my body size doesn't fit into a slot on a chart. So, although the blogosphere already has a cornucopia of excellent fat-acceptance bloggers, well, I feel the egotistical need to add my voice to the chorus.

One of the blogs I am LOVING is Kate Harding's Shapely Prose. She's wicked smart and a fantastic writer, and I'd happily read even her grocery list, if she posted it. Her most recent post, "Despite Being Obese, My 'Chances of Suffering from Obesity are Very Slim' ", is what moved me to drag this blog out of the mothballs.

Actually, I was motivated *specifically* by one of the comments in that post, in which the commenter talked about a shortsighted doctor who disregarded good cholesterol test results and still advised her to eat better and exercise in order to lose weight, without ever asking her about whether she already did so.

Goddamn doctors.

I have a primary-care doctor who I've been seeing for 15 years, and he has always told me that he doesn't care whether my weight fits into a slot on a chart; what he cares about is my actual health, as demonstrated by cholesterol/blood sugar/blood pressure/activity level, etc. He is OUTSTANDING. I don't know what I'll do if he ever moves away or retires. He just GETS it, you know?

A few years ago, I was seeing a psychiatrist because my insurance required that I do so if I wanted them to cover my Zoloft. So, 4 times a year, I checked in with the psychiatrist, we concurred that it's all good, he wrote me a prescription for Zoloft, and I went on my merry way. Then he left the practice, so I got handed off to another shrink in that practice, but I figured that since I would have to see her only 4 times a year, it would be no big deal.

(Obviously, there was a VERY big deal, or else this is a lame-ass post.)

On my second visit to her, literally the only thing that she asked me about my mental health was: "How was your summer?" When I said, "It was good," she didn't bother to ask further if it was good in the sense of going on vacation, or falling in love with a lifeguard, or if it was good in the sense of not wanting to jump in a running shower with a plugged-in hairdryer.

She, however, looked in my chart, and followed up on my blood pressure. (I had started taking BP meds about 6 months prior.) I told her that my BP was good, and my primary-care doctor said that if my BP stayed stable, I could go off the meds.

So then she asked, "What are you doing to try to lose weight?"

The sad thing is, that question didn't seem inappropriate. (Let me emphasize: THAT question didn't seem inappropriate.) It's just so commonplace for anyone and everyone to have an opinion on others' extra weight, that my *mental* health doctor asking me about my weight — a *physical* state of being — didn't even raise a red flag.

I told her I was exercising and keeping an eye on my diet. She asked, "How's that going?" I thought she meant how was keeping an eye on my diet going, so I said, "Well, I have a sweet tooth, but it's not too hard to keep under control."

She said, "No, I meant how much weight have you lost so far?"

Huh? Okay. I told her 10 pounds, even though I had no idea if it was true.

Then she asked me what I weighed. Finally, this was where I started to wonder how this related to my mental health. But because I had gone along with this line of questions so far, I figured I had to keep going along with it, and I thought that if I was resistant to the idea, she'd label me with some horrible psychological term (she was, after all, my shrink, and I had no idea what her analysis of me might mean in terms of my medical record), so I told her my weight. She asked me how tall I was, and calculated my BMI right then and there, and told me what my BMI *must* be if I wanted to be healthy.

HUH? The HELL?

Then she told me, "Well, try to lose weight on your own for now, and when you see me in 3 months, if you haven't made good progress I'll put you on a weight-loss drug." She got up, and bopped over to her desk, wrote the refill for my Zoloft, and a thought struck her! Did I know about Pilates? I should do Pilates! Pilates would be very good for getting rid of the fat around my waist!

All I could do was stare at her and wonder how many of her patients killed themselves.

As she walked me out, she said, "Now, 10 pounds in 3 months is pretty good, so really stick to your goals!"

This happened just about 3 years ago, and after that appointment, I never went back. The next time I saw my primary-care doctor, I asked him if he could prescribe my Zoloft, and he checked with my insurance, and said that he absolutely could. And he said that she was full of crap on the weight-loss drug plan. He has always been very opposed to weight-loss drugs, because he actually reads the results of drug studies, and he tends to think that a 5- to 10-pound weight loss (at most) isn't worth the side effects and potential drug interactions. (Not to mention the Alli poopy-pants.)

I *know* that I should have told that shrink as soon as she asked about my weight that I already HAD a doctor taking care of my physical problems and that she was there to take care of my insanity. I *should* have told her "Lady, I *know* I'm fat. I see myself naked every day. But I will not take diet drugs. And by the way, the BMI is pretty flawed, and I will never, not in a million years and no matter how much Pilates I take, have a BMI of 24. But I didn't. ask. you. Go fuck yourself."

I didn't say that, though, because I was a different person 3 years ago. A lot more conflict-avoidant, and believing that You Don't Contradict Authority (even when they're wrong).

But now? Well, I'm different now, and like I said above, I'm sick and tired of the bullshit.

Welcome to my blog.