What I’m saying, and what I’m not saying.

Since people seem to be awfully confused.

What I am saying: “Weight loss interventions have very low permanent success rates for most people.”
What I’m not saying: “No one in history has ever lost weight permanently in a healthy manner.”

Health At Every Size is, fundamentally, a weight-neutral approach, which means it focuses directly on health-supporting behaviours, and allows weight to adjust as it will. Sometimes it will adjust up, sometimes down, and sometimes it will stabilize. It is true that only a small percentage of people seem to lose weight permanently, according to research, but I do not deny that those people exist. Some of them may have even lost weight by using a HAES approach.

What I am saying: “People have the literal, legal right to eat any food they like, because human beings are condemned to be free. Food choices cannot make you a better or worse person, and food choices are only one factor among many that influence health.”
What I’m not saying: “No food choice ever has an impact on health, and you can eat anything you like without having it impact your health in any way.”

Food choices do impact health, but food choices have also been spun up in the media as the only or the most important thing that influences health, which is not accurate. (The largest impact on health actually comes from living conditions and other social determinants of health.) You are allowed, as an autonomous human being, to choose to eat any food that’s available to you – but, as an autonomous human being, you will also be the one to bear the brunt of the consequences of those choices. Health at Every Size includes a focus on intuitive eating and getting good nutrition because we believe a healthy relationship with food, and a good quality diet, can help improve people’s health. Eating well, in the HAES philosophy, is not the same as eating in a restrictive, restrained manner that is the current popular conception of “healthy eating.” Instead, it focuses on understanding internal signals of hunger and fullness, truly getting enough to eat, improving one’s attitudes toward food so that you are not feeling guilty or anxious, and getting balance, variety, and pleasure in the diet.

What I am saying:Weight is not a behaviour. Weight is a multifactorial trait that is highly heritable. It is not completely within anyone’s control, and no one can simply choose how much to weigh.”
What I’m not saying: “Weight is never, ever influenced by behaviour [see the first point, above.]”

In arguments about fat and health, people often enjoy claiming that fatness (a phenotypic trait) is opposite but equivalent to anorexia nervosa, an eating disorder with a specific set of behavioural and clinical diagnostic criteria. I think they do this because it gives their arguments (often very abusive, stigmatizing arguments) a veneer of respectable concern and clinical authority, but it’s a false equivalence. Fatness is actually the opposite of thinness, which is also a trait. Traits can be associated with diseases, they can even be implicated in diseases, or symptomatic of diseases, but they are not, in and of themselves, diseases. If you believe fatness is an eating disorder, then in order to be logically consistent, you would have to believe that thinness is also an eating disorder. It’s not. Binge eating disorder is a disorder, and it can cause people to gain weight. However, most fat people do not have binge eating disorder. Moreover, the treatment for binge eating disorder is not dieting and weight loss, it’s learning to eat normally and intuitively, without shame.

What I am saying: “Giving fat people the autonomy to make their own choices around food and exercise and weight, instead of abusing, threatening, and coercing them, is not only more ethical, but also more likely to result in people prioritizing their health in a way that makes sense for them.”
What I’m not saying: “Encouragement to eat well, exercise, or value one’s health is inherently oppressive to fat people.”

Health at Every Size actively encourages people to eat well and find activities that suit them, while not hating themselves. Random strangers on the street shouting abuse at fat people “for their own good”? No. Not acceptable. Doctors withholding effective treatment for certain health issues on the condition that fat people engage in a risky, non-evidence-based treatment (dieting)? No. Not acceptable, and not health-promoting. Well-meaning but ignorant, or even frankly abusive, family members or friends tossing off health advice to adults who have not solicited it? No. Not acceptable.

Black-and-white thinking is the order of the day when it comes to discussions about weight and health. It’s tempting, but don’t get sucked in. A fun trick I like to use, when I encounter two statements that seem to be totally at odds, is to ask myself, “Is there any way both of these things can be true at the same time?” (e.g. Is it possible to believe both that fat people may have a higher risk of disease, and that they can take steps to gain health without losing weight? I think so!) Reality is usually complex enough to sustain seeming paradoxes. Sniff them out. They are good medicine for dichotomous thinking.

break50

Refreshing nuance in comments.

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69 Comments

  1. Elisa
    Posted April 7, 2014 at 11:46 am | Permalink

    This is neat! In the final clarification, though, don’t you think that the term ‘fat people’ or ‘fat person’ is damaging, in itself?

    Perhaps ‘overweight’ or ‘persons of size’ would feel less demeaning to ‘overweight people’ or ‘people of size.’ Speaking from experience, the title ‘fat’ is not exactly empowering to myself or to others, to make necessary changes for better health. Feeling poorly about oneself and one’s weight can help to keep a person in the cycle of poor health choices.

    • Posted April 7, 2014 at 11:50 am | Permalink

      No, I do not. I call myself a fat person, because it is a reclaiming strategy. It’s okay if you don’t want to apply the term to yourself, and I would not apply the term to any individual who preferred another term. I use it on this website as a general term, but in a specific context. I actually think the term ‘overweight’ is quite damaging, but I would never go to a self-identified ‘overweight’ person’s website and suggest they change their language. You seem a little lost.

      • Katie
        Posted April 29, 2014 at 10:55 am | Permalink

        First comment– something I’ve been wondering for a while regarding nomenclature.

        I’m someone who has always had thin privilege. Over the last few years, the notions I was raised with stopped making sense, and reading your blog as well as others has really given me a vocabulary with which to consider weight and society. Having thin privilege, this isn’t really my space (which I understand!), but I don’t want to perpetrate the negative ideas that I used to hold and perpetrate (albeit unconsciously). So I do my best to be an ally, so to speak. I’m not sure what term is best for ME to us. As you said, “fat” is a reclaiming strategy, and as such, it doesn’t seem to be something I should be throwing around, as a member of a privileged class. I feel like it might shame people around me who are unfamiliar with fat politics and/or HAES. But I totally understand your explanation of “overweight” and why that is damaging. As such, I don’t want to use that either. Is there a positive term for me to adopt in referring to people of size/big people/helpIdon’tknow?

        • Posted April 29, 2014 at 5:43 pm | Permalink

          I think it’s probably best to use whatever people self-identify as (whether that’s “overweight” or “fat” or whatever.) But in cases when you are referring to people generally and can’t know how they all self-identify, you can still use the term “fat,” although some people are possibly going to be offended and you may need to explain yourself. You could do a little asterisk explaining your use of the term. Or you could try using an even more neutral descriptor. I often use the term “large people” or “larger people” when I’m talking about fat people in a non-fat-acceptance environment. It’s not perfect, since people can be “large” in many senses other than being fat, but it seems to get the job done.

          Other ideas from commenters are welcome, of course. This is just how I do things.

    • KellyK
      Posted April 7, 2014 at 12:10 pm | Permalink

      “Overweight” implies that I’m over the weight I’m supposed to be. “Fat” although it gets used as an insult enough to feel like one, is really just a descriptor. I’m a fat, white brunette who wears glasses. That’s a perfectly neutral description, and I would not be offended if you called me any of those things. It’s when you start assuming that my body size is the result of feeling poorly about myself and making bad choices that I begin to be offended.

      • Posted April 13, 2014 at 8:02 pm | Permalink

        Agreed.

        As a person with a history of disordered eating, it’s taken me a long time to recognize that this weight is the weight I am supposed to be at. Just in terms of optimizing my physical health in the context of my actual life.

        Let alone that, you know, I could be any weight at all and still not need to conform to society’s expectations of weight.

      • Sarah
        Posted April 23, 2014 at 10:00 am | Permalink

        I feel we internalize everything and it becomes a part of who we are. “I am fat,” is very different from “I have fat,” which is much more empowering. In English we tend to use “I am” a lot more than other languages.

        Take French, for example. The French say, “Je suis faim,” which means, “I have hunger,” and “Je ne suis plus faim,” which means, “I no longer have hunger.” Their language allows for the hunger to be something you experience, not something you are, which enables you to feed the hunger and stop when there is no longer hunger.

        If you consider fatness an undesirable trait, then owning fatness is a lot easier to ‘get rid of, release, let go…’ than if it’s something that we are, which is more akin to wishing my eyelashes longer.

        • Helen
          Posted April 23, 2014 at 7:10 pm | Permalink

          Sorry but you got mixed up – your translation is correct but your French isn’t! Je suis = I am. You say ‘j’ai faim’ or je n’ai plus faim….
          :-)

      • graythomas
        Posted July 27, 2014 at 11:34 am | Permalink

        My question is this: Can someone get to the point where they convince themselves they “accept” and “feel good about themselves,” despite the fact the evidence clearly observed is they don’t feel good about themselves, and are living an overall lifestyle that is unhealthy?

        I always was into sports, competition, eating good, however, my weight-height ratio was always considered too much for my frame. Despite the fact I outperformed everyone in my unit – I was in the “fat-boy” program, received demerits, and refused promotions because of this. I was 35-45 pounds “over-weight.” I can tell stories about being ridiculed and used as a “model” for “how to not be.”

        But, there were/are also people who eat nothing but “poop” food, are unhealthy, 100+ pounds, etc. and say they are happy the way they are. But they are constantly at the physicians office with a myriad of ailments, and live very limited life styles because they cannot physically do things that might bring them a better quality of life and enjoyment.

        For someone is in this category – how do you reach them – especially when they are – obstinate!??

        ____________
        “Overweight” implies that I’m over the weight I’m supposed to be. “Fat” although it gets used as an insult enough to feel like one, is really just a descriptor. I’m a fat, white brunette who wears glasses. That’s a perfectly neutral description, and I would not be offended if you called me any of those things. It’s when you start assuming that my body size is the result of feeling poorly about myself and making bad choices that I begin to be offended.

        • Posted July 28, 2014 at 10:58 am | Permalink

          But, there were/are also people who eat nothing but “poop” food, are unhealthy, 100+ pounds, etc. and say they are happy the way they are. But they are constantly at the physicians office with a myriad of ailments, and live very limited life styles because they cannot physically do things that might bring them a better quality of life and enjoyment.

          For someone is in this category – how do you reach them – especially when they are – obstinate!??

          The best way to reach them is to listen to them, validate their feelings, and refrain from giving advice until they ask for it. The best way to reach them is to support their sense of autonomy and self-worth. When they believe they are worth taking care of, and when they believe that they alone have the authority to make decisions about their body, they will prioritize their health in a way that makes sense to them. But if they are badgered into feeling they have no autonomy, and if they are continually receiving messages that they are failures and their body is not valuable, they will continue to treat themselves poorly and suffer for it.

        • Posted July 30, 2014 at 6:29 am | Permalink

          I know that by “poop food”, graythomas does not mean “food high in insoluble fiber”… but I sort of feel like that’s what it should mean.

    • Twistie
      Posted April 7, 2014 at 12:19 pm | Permalink

      I would add, Elisa, that ‘fat’ as a simple descriptor has a long history. Again, as Michelle says, you have every right to choose the descriptor you feel comfortable with for yourself. For myself, though, I prefer to call myself fat. What would make me feel more stigmatized is the idea that I would have to call myself by some term I find coy and evasive when there’s a perfectly correct term that appeals to my preference for blunt accuracy.

      Your mileage may well vary, but the day I was introduced to the concept of fat as a neutral self-descriptor, I felt as though I had found a personal suit of linguistic armor to help me navigate slings and arrows of body hate. It helps me love my body and care for it better. I can’t take good care of something if I cannot accept what it is.

      So find what works for you. Use it and don’t ever apologize for your choice. But for me, this is why ‘fat’ is an important part of my body acceptance activism, as well as my personal ability to care for myself.

    • jsj
      Posted April 8, 2014 at 3:01 pm | Permalink

      I like “fat”. And “corpulent”. And “rubenesque” will do in a pinch, no pun intended. “Rotund” is okay, too. But “fat” is pretty straightforward. I probably like other words because I am a (sometimes) writer. ;)

  2. Posted April 7, 2014 at 12:07 pm | Permalink

    Michelle – you rule! This post is now bookmarked for any and all conversations about weight. :)

  3. sannanina
    Posted April 7, 2014 at 12:29 pm | Permalink

    Thank you for doing this. I hope you do not too get tired of clarifying these things again and again and again… They are important and they need to be said – and I am very thankful that you take the time saying them :o)

    Also, and just because it is a topic important to me, I would like to add that shaming people with binge eating disorder is not just mean but also counterproductive because binge eating disorder thrives on shame. Being ashamed of your (fat) body and believing that being fat automatically means you are eating too much can contribute to a) not believing/ignoring your hunger signals b) disidentifying and dissociating from your body which in turn can actually contribute to binges. At least this has been my experience. This is also the reason why I would argue that binge eating disorder is not the opposite of anorexia. Rather, binge eating disorder and anorexia have some symptoms that are opposite of each other (restriction vs. bingeing, weight loss vs. weight gain) and some symptoms that are actually quite similar (body dissatisfaction, a lot of cognitions). Of course, things are even more complex in reality, but considering that I have even heard psychologists who really should know better state that binge eating disorder is the opposite of anorexia, it would be a vast improvement if people would understand this.

    • sannanina
      Posted April 7, 2014 at 12:36 pm | Permalink

      Gah! I forgot to close a tag apparently…

      • Posted April 7, 2014 at 12:38 pm | Permalink

        I got it for you.

        P.S. Do you know of a good overview (a book or article) in English that discusses the most common cognitions in eating disorders? I would love to have a resource like this to review.

        • sannanina
          Posted April 7, 2014 at 12:38 pm | Permalink

          Thanks.

        • sannanina
          Posted April 7, 2014 at 5:49 pm | Permalink

          Unfortunately I don’t know of a good review – but I did a quick literature search and I found some papers that might interest you – I will send a mail.

          Maybe I should also clarify that I was talking about my personal experiences above. It is, however, well documented that people with BED show strong concerns with weight and body shape was far as I know. In addition, there is evidence that eating disorders can “morph into each other” as far as I am aware. Which again also suggests that they are not opposites.

          In general, I really wish that there would be more qualitative studies on the cognitions and emotions associated with eating disorders. Most psychological studies use multiple-choice questionnaires – and that’s great for quantifying things. But open questions (e.g. “What do you feel after bingeing?” “What do you think about your body?” “What are your associations with food?”) really might be a good way to generate research research questions in the first place.

          • Posted April 7, 2014 at 6:14 pm | Permalink

            Awesome, I would love it if you could email me. And I agree, that would be really useful.

          • sannanina
            Posted April 7, 2014 at 6:30 pm | Permalink

            Found this blog post which might interest you in the current context: http://learningtotreadwater.blogspot.de/2011/03/morphing-disorders.html

          • Heather
            Posted April 8, 2014 at 12:52 pm | Permalink

            I’ve also had personal experience of my eating disorder morphing. I started with anorexia, which morphed into bulimia and then binge eating disorder. My psychology was the same throughout – only the behaviours differed. Binge eating behaviours are the opposite to anorexia behaviours, but caused by the same psychology, in my own experience.

            I think of it as my body rebelling against starvation that caused the bingeing behaviours to emerge.

  4. Judybat25
    Posted April 7, 2014 at 1:41 pm | Permalink

    Thank you so much for this and for all that you do. I love how you write. I’m also bookmarking this for later reference.

  5. Posted April 7, 2014 at 3:00 pm | Permalink

    Thank you, thank you! You hit it out of the park as usual. The “fatness is the opposite of anorexia” error in particular drives me nuts. I fully admit that failing to get something out of the program due to one sticking point is my own issue, but when I recently went through a popular local program to end binge eating called The Hunger Within Workshop, I basically put up a wall the first week when we were asked why we were there. (Real answer in most cases: required counseling for WLS, not that there’s anything wrong with that.) When I emphasized (mostly because I was getting really anxious and uncomfortable about the others’ answers) that I was there because my eating behaviors caused me stress, not just because I was fat, I got these polite blank stares like nobody (including the instructor) could relate to that in any way. Everyone else seemed to feel that it was self-evident why they were there: We’re fat! Most of the personal anecdotes shared throughout the class were like “my mother used to bake me cookies and so I associate someone baking for me with love” (um, yes, to me that can be one way to show love… it’s not like fat people are the only ones who have had this experience) or rueful tales about how the person couldn’t stop herself from getting the burger instead of the salad with the underlying message that if she were “normal,” this wouldn’t be an issue. I was so disappointed that I got nothing out of it because people around here put a lot of stock in this program.

    I just felt like we were being set apart as fundamentally different from the instructor, who was very thin. I felt like she was a compassionate person and cared about me and my well-being, but not as an equal. I just couldn’t get past that. Well, that and I asked her if there were publications on the success rate of the workshop because I honestly felt that would allay some of my fears, and she didn’t really seem to know what I was asking. Again, I don’t mean to bash her because I’m sure she knows what she is doing, but the whole experience was very frustrating and saddening.

  6. Erin
    Posted April 7, 2014 at 3:55 pm | Permalink

    I love this! I struggle sooo much with disordered eating (mainly binge eating) and constantly obsess about food. Im not fat by society’s standards, but i do obsess about losing weight. I would like to get a low body fat and have a celebrity body (i might sound vapid or superficial but its the truth) but eating just protein and fruit and veg leaves me feeling deprived and hungry.its all a process, and i do like the idea of intuitive eating and listening to my body, and agree that weight is not indicative of health but i also want to be thin and maintain a thin body throughout my life. Im torn. I totally agree that shaming people about their weight does not help them out. I was 80lbs heavier 5 years ago and i actually had food thrown at me on the street and been slapped for being fat…..but i would just eat more to comfort myself for the abuse i was getting… love you and your work. Its certainly refreshing and its a logical approach to eating. I hope i can eventually get to a point where im not weird or obsessive.

  7. Marie
    Posted April 8, 2014 at 1:00 pm | Permalink

    OMG! Could this be any more clear?!? I can’t imagine someone having any issues with how you’ve outlined the above but I know in my heart they will still see fat as they’ve always seen fat – a failing on the part of the fat person in some way.

    I guess all one can do is to continue to speak the plain truth as they see it through the din of false and misleading information until it finally lands in enough minds to create a tipping point.

    Thanks again!

  8. Posted April 9, 2014 at 1:26 pm | Permalink

    This is wonderful. :)

  9. IrishUp
    Posted April 9, 2014 at 1:35 pm | Permalink

    LOVE! THIS!

    “Weight is a multifactorial trait that is highly heritable.”

    :: dons ED advocate hat, steps onto soapbox ::

    A clarification: Eating disorders are ALSO phenotypic expressions of highly heritable genetic traits.

    The difference is that EDs are biologically based *brain *disorders, which become phenotypically expressed due to a complex interaction of a person’s developmental stage, experiences, environment AND genetic heritance. Whereas weight / body composition is, um, NOT a brain based behavioral disorder.

    It is quite common, though not by any means UNIVERSAL, for an ED to impact weight and body composition. The reverse does not hold true *per se* – that is, hella environmental and experiential mediators interacting with how one’s (perceived) weight operates therein, can be PRECIPITATING CONDITIONS to expressing ED. BUT – it’s not the weight/ body comp in and of itself.

    All those same conditions will NOT “cause” an ED, absent the biological predisposition. Most estimates put it at something like 80% of USian women have engaged in disordered (restrictive) eating at some point, while the lifetime risk of any ED is ~5-8%. Clearly, these are not the same entities.

    Assuming that you can tell ANYTHING about a person’s eating habits or health – including mental health – based on their body habitus is simply out and out mistaken (as I know this community well knows). Conflating EDs with “obesity” or “overweight” is more than mistaken – it leads directly to harm in the forms of misdiagnosis, under-disagnosis, and faulty medical treatment and advice. It leads to creating an environment where recovering from ED is made exponentially harder than it has to be.

    :: off soapbox ::

    As you were!

    • sannanina
      Posted April 9, 2014 at 3:05 pm | Permalink

      I know that I am kind of contradicting the dominant position in the ED community here – but I have a real problem with the description of EDs (and, in fact, all mental illnesses) as brain diseases. Let me clarify this. Of *course* you can find reflections of EDs and all other mental illnesses in the brain. To a certain degree this is actually trivial statement. Our brain is the location of all our thoughts and emotions, and our behaviors are always caused by processes in the brain. And yes, there appear to be genetic factors that influence human phenotypes in ways that predispose the respective person to develop an ED. But I am concerned that the one-sided current focus in psychiatry and to some degree also psychology on biological traits is misguided.

      First of all, your statement concerning the causes of EDs could easily be turned around – you could say “environmental factors cause EDs in people that are vulnerable due to genetic traits”. The statistic analysis underlying these statements is actually the same – in both cases you look for an interaction of genotype and environment.

      Second, as far as I am aware, all EDs are polygenic, i.e., they are influenced by many different genes. This makes it very, very hard to estimate heritability. Also, heritability of polygenic traits is a matter of degree. You are not either predisposed or not predisposed to a polygenic trait – instead you are more or less predisposed. Furthermore, many of those traits influenced by those genes might not have a direct, obvious connection with EDs but rather with traits influencing EDs such as perfectionism which are themselves shaped by a genotype x environment interaction. Also, epigenetic mechanisms play a role, and epigenetic changes are actually due to environmental influences (though those influences might look very different from what we usually consider as the environment of a person).

      Third, I don’t think the argument that most people who engage in disordered eating ever develop a full-blown ED really speaks against social influences on EDs. Social influences are highly individual and depend on a lot of factors. Furthermore, not all the social influences relevant for the development of an ED need to be directly relevant to food intake or body image and therefore might be harder to spot. For example, things like previous trauma or current stress might also play a role. Also, I am not sure if it is really the case that you either have an ED or don’t have an ED. To some degree, the point at which a behavior is judged as clinically relevant is arbitrary, at least with the current diagnostic criteria. (This is true for most mental illnesses, by the way.)
      Finally I believe that thinking of EDs exclusively as genetically caused brain diseases is not helpful for the development of ED treatments because it suggests that the best route to treat EDs would be treating them with biologic means – e.g. with medications. That might be one useful approach, but it totally ignores a lot of other factors that might help in ED prevention and recovery.

      Having said that I am by no means an expert on this topic – so if you have evidence that contradict my points I would be very thankful for the opportunity to increase my understanding of EDs.

      • sannanina
        Posted April 9, 2014 at 3:17 pm | Permalink

        On the other hand: After rereading your comment I am not sure if anything what I just said actually is at odds with what you have said. Just to clarify where I come from: I a fat person with a personal ED history as well as with several cases of EDs in her immediate family (the EDs in my family are all over the place, though, ranging from anorexia to BED). I am also research psychologist who is interested in clinical topics but is not doing ED research or in fact any other type of clinical research. In fact, I am a social psychologist. I would currently define myself as a social psychologist working in personality psychology. Given my background I am perpetually frustrated with how many psychiatrists, clinical psychologists but also personality psychologist approach the influence of the environment – which hopefully explains my rant :o) In my opinion, we are often not asking the right questions – or at least just a very small subset of the right questions.

        • IrishUp
          Posted April 10, 2014 at 10:22 am | Permalink

          sannanina – I think we are in agreement, or at least, I agree with your points w/r/t polygenic, predisposition existing on a continuum, HIGHLY mediated by cultural factors (as are most if not all serious mental health diagnoses), trauma increasing risk of expression, not asking the right questions and so forth.

          You raise many important points regarding the value of, limits of, and dangers of describing EDs as genetically based & etc. In particular, thank you for speaking up as someone with direct lived experience; my orientation is as a parent and general social justice advocate. I try to balance my interpretations of the best, modern primary research into EDs against the fact that I can never know what it is like to have been or be *inside* of one. However measured and carefully I approach this issue, I must be mindful that I will always run the risk of underestimating certain kinds of harms.

          I do not want to derail Michelle’s larger conversation, but I’d be happy to point you in the direction of good resources and/or continue this discussion. IRL, I’m a clinical researcher (NOT in ED) with a psych/anth background, and a moderator on a parent support forum – Around the Dinner Table; I’ve written a lot there as IrishUp and can be emailed through that forum.

          May I also recommend these blogs – both scientifically oriented and written by people with lived experience:

          Carrie Arnold @ ED Bites
          Tetyana @ Science of Eating Disorders

          Best,

    • Posted April 9, 2014 at 3:55 pm | Permalink

      Thank you, that’s really interesting!

  10. Michelle
    Posted April 10, 2014 at 2:03 pm | Permalink

    I think that the work you have done is amazing. I have been reading your posts for a couple of years now and when the food noise becomes too much in my head, I look to this site to calm myself down. I think that people have become brainwashed by the diet industry to view food as good or bad or “super foods” etc, but food is just food. It’s when we use it as anything else it gets us into trouble.

  11. Posted April 11, 2014 at 11:34 am | Permalink

    I LOVE this!!!! I appreciate how you clarify each topic. <3

  12. AJ
    Posted April 12, 2014 at 2:55 pm | Permalink

    Thanks so much for this.

  13. Mich
    Posted April 13, 2014 at 12:07 am | Permalink

    I found this site, youreatopia.com through a comment on Chris’s blog. (Chris’s blog is fantastic too.) I’ve been reading it for the past couple days. On it, there was a link to this news article that I think should be read by all: http://www.timescolonist.com/opinion/comment-eating-disorders-deadly-for-older-adults-too-1.846474 It talks about the lack of treatments available to older women, even though 80% of those suffering are over 45.

    I think it’s related to the “younger women can still contribute/have some years left” attitude, whereas older women/seniors are less likely to have more babies. In this scenario we are still baby making machines. Science in the service of gender ideals.

  14. Go Kaleo
    Posted April 23, 2014 at 9:13 am | Permalink

    Girl, I feel you. Love this post, it resonates, and I get the same thing when I say these things. Shared, and thank you for addressing this so eloquently!

    • Posted April 23, 2014 at 5:31 pm | Permalink

      Thanks Amber. My stats definitely indicate you’ve shared, haha, so thank you for that too!

  15. Posted April 23, 2014 at 11:04 am | Permalink

    Hi Michelle, I finally got to use the “let’s just enjoy this” line at our family’s Easter dinner this past weekend. As the comments turned to “oh we’ll need to go for a walk after eating this” I said “let’s just enjoy this, it’s not about calories in/calories out.” which my nephew’s fiancee said “it is when you are trying to fit into a wedding dress in a few months” (ok well point taken).

    WARNING THE FOLLOWING COULD BE TRIGGERING

    I have a question. A medical professional my husband primarily sees – although I’ve had appointments with her too — constantly brings up to both of us, , about how much weight her husband’s lost, how much weight she’s lost, on such-and-such diet, all about the diet etc.

    Anyways I think these comments of hers about how much weight everyone’s lost and a description of the diet they’re on to do so are just some passive aggressive attempts by her to tell us “you’re fat, you need to lose weight.”

    She’s brought up my weight before in a more direct manner (oh your health isn’t good, you are overweight). I don’t think she’s ever brought up my husband’s weight.

    (this woman is a massage therapist by the way)

    Would be interested to hear thoughts on this. I feel like telling her to eff off.

    Thanks.

    • Posted April 23, 2014 at 11:57 am | Permalink

      Haha, I still think that even for people dieting pre-wedding, worrying about the calories at a single holiday meal is A BIT MUCH, but okay. If she wants to ruin her own Easter dinner, that’s her call. She can count calories without disparaging the food other people are actively enjoying. I think it would be nice if people would be aware of how those comments affect OTHER PEOPLE. It’s not worth getting into it with her about whether or not she should count calories or whether it will make a difference in her weight, but to point out that it puts a damper on other people’s enjoyment, because…yeah. Then it becomes an issue of etiquette.

      Regarding the massage therapist, you can go two routes: indirect or direct. You could just smile and nod and say, “I’ll think about that,” or “How interesting!” if she mentions weight stuff, immediately throw it in your mental garbage bin, and change the subject entirely. Redirect by asking her a question about some other topic.

      Directly, you could confront her by using the DEAR MAN technique, a really useful thing. You could write out a script ahead of time if you want to confront her. Here’s how it works:

      Describe the facts of the situation: “You just said/implied something about my weight, even though I have not solicited your advice or opinion about it.”
      Express your feelings about it: “That makes me feel ____ (awkward, judged, self-conscious, upset, whatever.)”
      Ask for what you want her to do: “I’d actually prefer if you just skipped making those comments altogether.”
      Reward her for doing what you want: “That way, I can enjoy spending time with you more and things won’t become awkward between us.”

      [Let her talk]

      stay Mindful of what you want, and repeat your request as necessary: “I hear what you’re saying/I see where you’re coming from, but I would still prefer if you just didn’t make those comments.”
      Act confident: maintain eye contact, don’t fidget or shrug or duck or apologize
      Negotiate if needed: “If you’ll agree to stop making those comments, I’ll ______ [stop criticizing something about her, or give her something she wants that seems reasonable for the situation – like listen to her blather about her cats or show you all the pictures of her sister’s baby or whatever.]”

      Hope that helps!

      • Posted April 23, 2014 at 5:48 pm | Permalink

        Thanks Michelle. I will be making note of that “Dear Man” technique for this & other situations. So hard to talk about some things.

  16. Posted April 27, 2014 at 3:08 pm | Permalink

    The trick is to have a consistently healthy diet and lifestyle.

  17. Posted April 29, 2014 at 8:14 pm | Permalink

    I was reading the storify of some of your #notyourgoodfatty tweets and thinking about what goes through the minds of the “I’m angry at you because I work so hard!” people. I think it’s pinging their ‘UNFAIR’ detectors–“respect is something I earn by doing this hard work to look pretty and do health behaviors. Wait, that person says they should get respect FOR FREE? Without doing the work that I have done, just because they’re a human being?” (Note–this isn’t conscious or at least not totally conscious–it is a verbal summary of what their brains are doing nonverbally.)

    Not so different from the type of people who might think that it’s unfair that taxes are taken from them and given to the ‘lucky duckies’. “I worked hard to get where I am” doesn’t mean that hard work would have been enough without luck and privilege (both in the jargon sense and the colloquial sense).

  18. Bert
    Posted May 1, 2014 at 10:34 am | Permalink

    What research are you aware of that says that sustained behavioral changes do not work for most people? The research I am familiar with credits most people’s failure to achieve lasting weight loss to the failure to sustain behavioral changes.

  19. Nina
    Posted May 3, 2014 at 2:28 pm | Permalink

    Well, why *are* you saying this? Food doesn’t exist in a vacuum. It is nourishment that grows out of fellow living things. What kind of food you choose to consume is absolutely a reflection of an ethical recognition that human beings are not the only species that deserves health, prosperity, and happiness. If your food choices support factory farming, corporations that displace traditional farmers and farming systems, vile treatment of animals and human workers, practices that adversely affect long-term sustainability of soil, usage of pesticides, preservatives, additives, or other chemicals in general shown to increase incidences of diseases and mutations, et cetera, why should you demand absolution from your unethical, selfish, and myopic choices?

    • MamaCheshire
      Posted May 3, 2014 at 9:33 pm | Permalink

      Because NONE of those choices are made in a vacuum.

      Because being a Judgey McJudgerson to people who are trying to go about living their lives is the exact polar opposite of the behavior that is likely to get anyone to consider making such “beneficial” changes as they are actually able to make.

      That’s why.

      • Nina
        Posted May 3, 2014 at 10:29 pm | Permalink

        If your impetus for not trying to rectify a wrong is that people might judge you for perpetuating the wrong, on what grounds do you think any consideration and respect it owed to you?

        Everyone is trying to go about living their lives. Pretending that some do so without causing more harm than others doesn’t serve any point. But you don’t get to parade around screaming for social justice for one group of people while demonstrating perfect apathy to the issues of sustainability, labor rights, pollution, and various animal and human abuses that take place under the umbrella of mass food production, issues you are directly contributing to by paying into the system.

        It is not incumbent on me, or any other person, to teach you how to behave in accordance with your own moral principles.

        • sannanina
          Posted May 4, 2014 at 5:52 am | Permalink

          Nina: If you read several articles on this blog you will see that Michelle DOES care about the social and environmental impact of food production. She also has stated repeatedly, though, that these things are best approached on the SYSTEMIC level, and that a given individual has only limited possibilities to affect the system by consumer choices.

          But you don’t get to parade around screaming for social justice for one group of people while demonstrating perfect apathy to the issues of sustainability, labor rights, pollution, and various animal and human abuses that take place under the umbrella of mass food production, issues you are directly contributing to by paying into the system.

          You did not state this explicitly, but this part of your comment sounds as if you conflate body size with overconsumption. If this is not the case, I apologize. If you DO in fact, believe that being fat is evidence of using more than one’s “fair share” I would like to also point out to you that a) income is inversely correlated with body mass in industrialized countries – i.e., the poor are more likely to be fat than the rich, yet, the rich are the ones that are responsible for most consumption and b) food choices are far more limited for low-income people.

          • Posted May 4, 2014 at 6:15 am | Permalink

            If you DO in fact, believe that being fat is evidence of using more than one’s “fair share” I would like to also point out to you that a) income is inversely correlated with body mass in industrialized countries – i.e., the poor are more likely to be fat than the rich, yet, the rich are the ones that are responsible for most consumption and b) food choices are far more limited for low-income people.

            This. I am so sick of people doing the equivalent of flying to Europe twice a year and then complaining about the environmental damage done by 4-wheelers.

        • sannanina
          Posted May 4, 2014 at 6:16 am | Permalink

          One more thing: As a consumer, it is usually very hard to actually find out which choices DO have the net least negative impact on other humans, other living beings in general, and the environment. For example, is it better to buy locally grown, but conventionally farmed or imported, but organically grown produce? Is it better to buy at the grocery store around the corner, i.e., a store in walking distance, or at the farmer’s market in the next town? Plus, I don’t always have the energy and time to consider these things as carefully as I would like to, and I guess that it is the same for other people. To consider these choices carefully, I would have to use time and energy that I then could not use any longer for other things that might benefit society, such as spending time with my students or volunteering at a crisis hotline.

          Personally, I DO want people to think about how their choices impact others and the environment. But I know that they will need more easily accessible, reliable information to actually make these choices with as little cost in terms in time and effort as possible. I also know that the choices I make daily will never be perfect – because I am human. But perhaps most importantly, I do not judge others on their food choices, because I know that I cannot really know all the factors that cause them to make these choices.

          • Posted May 4, 2014 at 9:24 am | Permalink

            There’s a really interesting blog post on this topic here – http://meloukhia.net/2013/04/can_you_shop_your_way_out_of_a_broken_food_system/

            I think that, if people have the resources, they should definitely think more carefully about how their food purchases impact the overall system and environment. But I also think that can’t be the beginning and end of our efforts to change the system and save the environment from disaster. I think, especially for people without resources, voting (or other organized political action) for better industry regulation and food distribution is probably more effective in the long run.

          • sannanina
            Posted May 4, 2014 at 9:53 am | Permalink

            This is about building a house not buying and eating food. And yet I think some of the points raised are relevant for all kind of consuption (i.e., we often don’t know what the most ethical choice is because we either do not have information about all relevant parameters or we fail to take them into account):

            http://www.ted.com/talks/catherine_mohr_builds_green

          • Twistie
            Posted May 4, 2014 at 10:27 am | Permalink

            Plus there’s the fact that some of us don’t have the luxury of even considering those questions simply because we lack the funds to make choices based on sustainability or moral issues.

            If I have five dollars in my pocket to feed myself and my husband for an entire day, I literally cannot concern myself with whether the crops used contain GMOs or whether the eggs come from free range chickens. I know I cannot afford the foods made with ethical/sustainable ingredients.

            I would love to pay more attention to those things. I would love to be able to feed my husband the low-carb diet that would help him manage his diabetes better.

            But right now, I’m just thrilled that I found a ten-pound box of pasta on a blowout sale for three bucks while I had three bucks in my pocket. Further, I’m glad I have a working stove and that the water has not been shut off this month so I can cook it.

            To be blunt, not everyone is as lucky as I am, let alone lucky enough to consider ethics in their groceries.

  20. Maragon
    Posted May 3, 2014 at 4:13 pm | Permalink

    Hi there.

    You state: “Weight is not a behaviour. Weight is a multifactorial trait that is highly heritable. It is not completely within anyone’s control, and no one can simply choose how much to weigh.”

    Do you have an citations for this claim that don’t involve a Huffpo post from a guy trying to sell a book on the subject?

    • sannanina
      Posted May 4, 2014 at 5:40 am | Permalink

      Do you have an citations for this claim that don’t involve a Huffpo post from a guy trying to sell a book on the subject?
      Just a tip: Michelle usually provides evidence for her claims in form of peer-reviewed papers on this very website – top of the page, tab labeled “Articles & Evidence”. Just a few of the references relevant for the claim you are questioning that listed on that page:

      http://diabetes.diabetesjournals.org/content/52/2/232.long
      http://www.nature.com/nm/journal/v10/n6/abs/nm0604-563.html
      http://www.nejm.org/doi/full/10.1056/NEJM199503093321001
      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2605663/

      There are many other relevant papers that you can find if you do a systematic literature search. However, as with all scientific peer-reviewed literature a lot of these papers will unfortunately be behind a paywall.

      I also would like to question the logic behind a claim such as “weight is a behavior” (or rather “weight is determined 100% by freely chosen behaviors” since this is what is probably meant). First, even if you ignore that no human behavior is completely under voluntary, conscious control as evidenced by mountains of psychological research on this topic, human metabolism is a complicated process with many steps. All those steps are influenced by things like enzymes, the permeability of biological membranes, gut bacteria etc. Those factors can potentially differ between humans because of genetics, social environmental factors such as stress which can influence, for example, hormone levels, biological environmental factors such as pathogens, medications etc. And all this can therefore potentially influence the efficiency of metabolism as well as how excess energy is used (e.g., does an individual build up additional body fat or muscle).

      In other words, it is not a reasonable suggestion that all people/bodies react the same to identical food intake (both in terms of food composition as well as amount) combined with identical levels of physical exercise. Actually, in some respects this seems to be universally accepted. For example, no one I know would expect that a man and woman of the same height and weight would react the same on identical food intake combined with identical exercise levels. We also generally don’t expect young and old people to react the same on these things. So why the hell would we not expect that different people of the same age, gender, height, and weight can react differently? It’s possible to debate HOW MUCH people can be reasonable expected to differ in their response to an identical food intake combined with an identical exercise level, even though that question cannot be answered without empirical data. But it is not reasonable to claim that there should not be a difference at all.

  21. Matt
    Posted May 14, 2014 at 6:55 pm | Permalink

    Well, I guess I’m fat at 6-foot-5, 260 pounds as I keep being told I’m fat, so I just wanted to let you know my belly thoroughly enjoyed the Faith No More in the video. :)

    I simply stumbled upon this and thought the ridiculous comments of people who actually care so much about other peoples’ appearances was laughable.

    Enjoy your raspberries.

  22. graythomas
    Posted July 27, 2014 at 11:04 am | Permalink

    I like your website and you make many good points – with which most I agree. However, do you not feel that the general impression is it will give the impression being 100+ pounds overweight – isn’t – unhealthy?

    My daughter is 28, 100+ pounds overweight. She says she is “happy” the “way I am.” Well, she does not live like someone who is happy. I see that her over-eating is due to being quite the opposite. She eats “no-thing” healthy – McDonalds, fast foods, cakes, candies, etc. As well, she feeds her son these things too. She is not physically active at all. She complains constantly that she feels terrible. She has the best of living conditions and plenty of time to do the things she needs, in a given day. She’s had an easy road to travel in life – and doesn’t take the opportunities to make positive choices and actions.

    Her choices now are all formed around the fact that she is unhealthy, is physically limited in the things she can and can’t do, and see’s the opportunities in a given day and in life all predicated upon the way she eats – and being 100+ pounds overweight.

    How do you reach someone in this – “condition?”

    • Posted July 28, 2014 at 10:54 am | Permalink

      It is understandable that you are worried about your daughter’s health. Any parent would be. However, whether or not your daughter is truly happy, she is 28 years old. She is an adult. That means she is the only one who can “reach” herself on this issue. It is not your job to “fix” her or to pressure her to be different. If she is truly unhappy, she will have to work that out for herself. The best you can do is offer her your unconditional love, and when she asks for it, support. The best thing you can do is listen to what she tells you about herself, not dictate to her what she should or shouldn’t do. If you know she is unhappy, but she insists to you that she is happy, you may take from this the following message: she wants you to leave her alone about this issue. The more you pressure her, the more she will resist.

      As to whether a certain weight is “unhealthy,” that really depends on the individual. Some people seem to maintain high weights in good health. It is not my, or anyone else’s, job to dictate to them whether they are truly healthy or not. That is between them and their doctor. My position is that taking the focus off of weight control, since it does not work for the vast majority of people according to quite a lot of research, is more likely to result in many people making better choices about their health independent of weight. I know that the issues of health and weight are very difficult to separate, given our cultural context, but that is what I think and that is why I write the things I do.

      • Posted July 29, 2014 at 8:04 pm | Permalink

        Apparently you have a lot more patience today than I do, Michelle. I was just going to link to the the bad advice tumblr.

        Seriously, though, great answer, great display of empathy.

  23. Posted July 29, 2014 at 2:24 pm | Permalink

    I am becoming more and more aware of how prevelant fat-shaming is in entertainment. The Big Bang Theory, for example (a show for the most part I love) constantly does it with the mom. Last night we watched “Last Vegas” and there was a swimsuit judging segment. All the thin swim-suit wearers got “10’s” and the plus sized swimsuit wearer got a “1”. ): Pervasive I Guess.

    Then there is the fat-shaming my friend got at her visit to the gynecologist for nothing to do with her weight. The gyne kept at her “well, are you diabetic yet?” “you know you’re estrogen dominant b/c you’re overweight” etc. etc. My friend was nearly in tears when she left.

    • Mich
      Posted August 4, 2014 at 9:54 pm | Permalink

      I too noticed that with Big Bang Theory. So I stopped watching it as of last Christmas. My mom’s clueless. Also the overt racism and anti-Semitism were getting a bit much for me.

  24. Posted July 30, 2014 at 11:24 am | Permalink

    I am curious about something: what if any role does simple, refined sugar play with respect to one’s mood, i.e. mood swings, anxiety, PMS, etc.?

    • Posted July 30, 2014 at 4:46 pm | Permalink

      I don’t really know. I suspect that it’s quite individual, and may be related to your overall blood glucose levels. If you have blood sugar swings (both high and low), it does impact your mood. It can make you cranky, sleepy, or confused. But not all people have those swings. It depends on how your body deals with metabolizing sugar.

      • Posted July 31, 2014 at 10:52 am | Permalink

        Does protein help stabilize blood sugar?

        • Posted August 1, 2014 at 7:10 am | Permalink

          Yes, it helps slow the entry of sugar into the bloodstream if you eat it with carbohydrates.

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