Friday, May 09, 2008

Mini-rant of the day

I just read something annoying on and got peeved and felt like venting.

This article tells the story of one Barbara Aldrich, who was 5'11" and 255 lbs. (OMG FAT!!!) and borderline diabetic. When she turned 50, she decided enough was enough, so she "traded in high-calorie, carbohydrate-laden meals and junk food for a diet of lean meats, vegetables, fruits and healthier snacks" and started walking every day. After 4 months, she lost 75 pounds and feels like a new woman, and now she does things like go on trips and get manicures. Of course the whole concept behind the story, along with what they say about Aldrich pre-weight loss and the notion that her improved health from eating healthy and exercising could only be measured by her 75 pound weight loss, is irksome and obnoxious. Same with the idea that it was her fat that prevented her from going on trips and getting manicures before, rather than society making her feel like shit about herself (and that what needed to change was her weight, rather than her attitude or anyone else's). But that's pretty much par for the course in this whole "Fit Nation" series, which is basically a bunch of "this person was fat and unhealthy like you, but s/he lost a ton of weight and now his/her life is totally perfect, and yours can be too if you just get off your ass" features.

One thing really stood out about this article in particular, though. First, they say that Aldrich lost 4 or 5 pounds per week and talk about how great that is. Then in one line that's not contextualized or integrated into the story at all, they point out that the Mayo Clinic website says that a weight loss of only 1-2 pounds per week is recommended. So on the one hand, they devote an entire article to making you feel like you should get out there and lose weight like Barbara Aldrich did, because it was so easy for her and now she's so much healthier blah blah blah. But then they point out that actually if you really did lose 4-5 pounds per week it wouldn't necessarily be a healthy thing. It's kind of like the "*Results not typical" that you get at the bottom of a Jenny Craig ad, but even worse because this one is more like "*Don't try this at home." I guess I ought to be glad they mentioned it at all, but somehow I'm not.

I also feel the need to point out Aldrich's quote at the end of the article: "I love myself, I love how I look now. I feel better, younger ... just a complete 360." OK, obviously she meant to say "180" (or maybe she even did say that and the reporter misquoted her). But I'm thinking this is a kind of interesting slip, because basically in terms of the way she thinks about herself, she really did do a 360. Before she lost weight, her attitude towards herself was tied up with her body size and she felt ashamed go out and do things she wanted to do. After she lost weight, her attitude towards herself is still tied up with her body size, so much so that only now after losing 75 pounds does she love herself. I think that is pretty sad.


Anonymous said...

I assume you'll delete this, but you're an idiot. The heart is specifically designed to beat so many beats in a life time based on use, and it simply takes more heart power to pump through 225 pounds than it does 150. This is a scientific, medical, fact. The idea that you can be fat is healthy is simply a dangerous and delusional way that you use to rationalize your own bad & ignorant behavior.

Having said that; it's a free country. Do what you want. Just stop lying about it.

Mary said...

Wow, I didn't know that any of my readers were cardiologists! I am really honored that you took time away from your laboratory to set me straight, Dr. Anonymous. Thank you so much for stopping by and informing me and my readers about the scientific, medical facts of how the heart is designed! If you could just point me to the reference in the medical literature where it says that the heart is designed for people who weigh 150 pounds, I would be really grateful so I wouldn't have to go around being such an idiot and a liar all the time.

One question: in all your research, did you figure out why it is that people who exercise are healthier than people who don't? Because based on your theory, it seems like anything you do to increase your heart rate (e.g., exercise) would actually shorten your lifespan since it would use up more of the pre-determined number of heartbeats that every person is born with. So based on your considerable medical expertise, do you recommend that everyone try to be as sedentary as possible?

I will eagerly await your advice!

Anonymous said...

Because as you increase your exercise, your heart rate actually decreases at rest. Which is what most people, even those who exercise a lot work for.

One of the goals of working out is to decrease your at rest heart rate.

Anonymous said...

Oh, any many thanks for the Dr. title, though I'm not sure it's required to know commonly held medical information.

I also know about some allergy medications, I suppose that makes me a pharmacist as well.

Mary said...

I didn't realize it was "commonly held medical information" that your heart can only beat a certain number of times. I just wish I knew what the magic number was!

I'm actually kind of puzzled as to why you came back here, Anonymous. I figured you for a drive-by troll. Maybe you just wanted to see if I deleted your comment. Or maybe you actually do have some doubts about the received wisdom on fat, despite your gruff exterior? If that's the case, I really encourage you to check out this blog about medical research on fat (written by Sandy Szwarc, BSN, RN, CCP) and this post by Kate Harding, which sums up a lot of the ideas of the Fat Acceptance movement.

If it turns out that you're not at all interested in these ideas, then I would just ask you to please go away. I didn't delete your post where you called me an idiot and a liar, but I don't have infinite patience either.

Anonymous said...

Yes, it is commonly held medical information that a heart can only beat so many beats in a lifetime; but no one, including myself ever argued that there is some magic number. Heredity plays a bigger role in the number of heartbeats than almost anything else. It's a muscle, and like any muscle, atrophies with age.

This is also why dog years are 7 years to human years, because their hearts beat faster and have less life expectancy.

Of course with advances in medical research, we might be able to grow new hearts or repair hearts with nano-organisims extending the life, but we haven't quite gotten there yet.

& FYI - I did call you an idiot, and for that I apologize. However, I didn't call you a liar. I said you are lying. This is also a common human foible that we all suffer from. We rationalize behavior that we like, even though it's bad for us. My vices just don't happen to be your vices.

Lastly - please know I honestly don't care what you eat, do, smoke, drink, put into your body, etc, etc, etc. So long as you don't negatively affect others without their agreement, you can do what you want.

None of this however makes you right.

Anonymous said...

I went to your links - and agree that models are TV are extremely unhealthy as well.

I also think BMI, commonly used as the marker for statistics stating X% of people are overweight, & Y% are obese is also idiotic. Any well developed athelete will weigh enough to have a very high BMI.

Again, none of this means that carrying 75 pounds of extra weight is healthy.

Mary said...

I appreciate your apology and the fact that you are willing to talk reasonably about things.

I still dispute what you are claiming, though. I think human biology is more complicated than you are suggesting, and I don't believe that there is a set number of times that a person's heart can beat. I also don't think that dogs' shorter life expectancy than humans' is directly related to their faster heart rate.

Even if life expectancy reduced to a number of heartbeats, you are assuming that being fat automatically means a person will have a higher heart rate. This is not necessarily true. In the past when I have calculated my heart rate it has been quite average, even perhaps a little lower than average. It is true that exercise can lower your resting heart rate. But you are conflating exercise with thinness. You are assuming that everyone who is fat does not exercise, and this is just flat-out untrue. Apparently you just happen not to know any fat people who exercise. I understand why people conflate these things -- it's because a sedentary lifestyle contributes to weight gain. But it does not follow from this that every person who is fat is sedentary.

It also does not follow that every person who is fat eats like a pig. Eating a diet high in calories and fat can cause you to gain weight, but this does not mean that if you're fat it's because you eat like a pig.

You talk about my "bad & ignorant behavior" and my "vices", but you don't know me at all. All you know about me is that I refer to myself as "fat". In previous posts I have talked a little about my vegetarianism and my interest in running, and the fact that I have run marathons. Already these things might give you some idea that I don't fit into your assumptions about what a fat person's lifestyle must be like. And I am not trying to act as if I'm the special exception; I think you'd be quite surprised to know how active and health-conscious a lot of fat people are. This woman does triathlons, for example.

Also, about the phrase "extra 75 pounds": "extra" compared to what? We know that BMI is a poor measure of health or even of body fat. Without BMI, I don't think there is any other widely accepted set of guidelines for how much a person "should" weigh. People have different body compositions based on genetics and developed muscle mass. So there is no single "ideal" weight for every person. Many people who look quite thin have been discovered to have a lot of visceral fat around their organs (and that's one type of fat that *has* been shown to be unhealthy), whereas a person with a lot of subcutaneous fat (i.e., a person who looks "fat") may actually have quite low levels of visceral fat. Exercise is apparently the best predictor of this, not BMI or body fat percentage.

In the case of this article that prompted your comment, the woman did have a health problem (diabetes) that got better with eating better and exercising. Well, of course. What I object to is the fact that the woman (and the person who wrote the article) blamed all her previous problems on the fat itself and focused on the weight loss. Articles like this just feed into people's stereotypes about fat, like the ones I mentioned above.

All this being said, health is not a moral imperative. Every person, fat or thin, healthy or unhealthy, deserves to be treated with dignity, and that is one of the major points made by the Fat Acceptance movement. The FA community (including me) believes that the health risks of being fat are vastly overstated in the media and even some of the medical literature. I'm not "lying" about it, I believe it based on the books and articles that I have read on the subject. But even if we were wrong, that wouldn't be a proper justification for treating fat people with any less than the decency and dignity afforded to any other person. I can't believe we even have to say that, but sadly we do.

Anonymous said...

We are still going to have to disagree I guess, but recent studies have shown a better determining factor than BMI for weight affects, is the ratio of waist to hip. A very large waist and smaller hips, generally on a "fat" person, is very unhealthy.

Due to these facts, I would suggest it's irresponsible to promote acceptance.

In much the same way I think business owners should be allowed to allow smoking or not, but I wouldn't go around arguing for "smoking acceptance."

People shouldn't be discriminated against for sure, but this isn't the same as arguing for acceptance.

On the other points - I concur. An ideal weight is individually based on genetics, but very strong atheletes with resting heart rates @ 50 BPM, will live longer than people with resting rates of 70.

FWIW - I'm average at around 70.

Mary said...

In some ways you're starting to sound more and more like someone who is a lot more open to fat acceptance than you are willing to admit, Anonymous.

Already you've conceded that BMI is useless. Now you are acknowledging that there is no ideal weight for everybody due to genetic variability, and you also seem to be claiming that not all fat people are unhealthy (just those with a particular body shape). All of these (minus the waist-hip ratio part -- you may be right about a correlation between a high waist-hip ratio and some diseases, but again there is a difference between correlation and causation) are ideas that people in the fat acceptance movement have been trying to get across.

What's missing from what you said is an acknowledgement of the fact that even if being fat were unhealthy, for the vast majority of people there is no reliable, safe way to lose weight permanently. The pressure to be thin combined with the futility of trying to get thin causes people to do horribly dangerous things to themselves like starving, purging, taking laxatives, taking other unsafe (and even deadly) weight loss drugs, and undergoing gastric bypass surgery. Exercise doesn't necessarily lead to weight loss, and dieting is unhealthy (and I've already heard the one about how "you don't have to 'diet' to lose weight, you just have to eat healthy" -- I know from personal experience that this is absolutely wrong). Given all this, until someone discovers a safe and effective method of permanent weight loss, I think that acceptance is actually the only *responsible* approach.

Anonymous No.2 said...

Actually Mary, there is a safe and effective way to permanently lose weight. It's called "eating a healthy and balanced diet at a slight calorie deficit and doing a lot of cardio and strength training until you reach your goal weight, then continuing to eat and exercise that way for the rest of your life."

I was going to add "I did it! So can you!" But then that would be hate speech, wouldn't it?

Mary said...

Oh really, I'm glad to hear it's so simple! I wonder why so few people manage to lose weight permanently... one of life's little mysteries, I guess.

Anonymous no.2 said...

Oh really, I'm glad to hear it's so simple! I wonder why so few people manage to lose weight permanently... one of life's little mysteries, I guess.

I never said it was easy, I just said it was possible.

jen said...

I don't know if you'll see this since this is an old post, but I felt compelled to write. I enjoy reading your blog, but what disturbed me about these comments is that you apparently do not know how to lose weight. I don't care whether you lose weight or not, but I wouldn't want you to not know how (whether you implement the information or not). As you know, dieting does not work. It has to be a lifestyle change so it's not easy. Each person just has to decide if it's worth the improvement in how it makes him/her feel. To me, I feel so much better that it's a no brainer, but it's an individual decision. Anyway, here's the deal: Eat lean meats, veggies, and whole grains (and nothing else). Since you're a vegetarian, substitute non-meat proteins instead (i.e. tofu, beans, edamame). Eat 3 meals plus 2 or 3 snacks a day, so that you're eating every 3 hours. That way you won't be hungry and your metabolism will increase. Don't use butter or heavy sauces or sugar. Don't count calories. Portion size (since it's so out of whack in this country) is a fist-size of carbs and a palm size of protein. That's it. Exercise is a plus but it's 80% what one eats.

Now, let me re-emphasis that I don't care what you look like or what you eat. It's a personal decision.

Mary said...

Jen, I appreciate your trying not to be rude, but you still come across as condescending, considering that I wasn't asking for dieting advice.

In fact I've lost weight many times. I've been on Jenny Craig and Weight Watchers ("not a diet!") more times than I care to count. Every time I lost at least 20-30 pounds, then eventually gained it all back. The time I was most "successful" at losing weight, I did it on my own without a program and I lost 70 pounds over the course of about a year, though a combination of exercising twice a day (a run in the morning before breakfast and at night after dinner, or one morning run and weight-lifting in the afternoon) and a low-calorie and low-fat diet. Every day I wrote down the number of calories and fat grams in everything I ate.

As I got older and my metabolism (presumably) got slower, and I got tired of counting every calorie that went into my mouth, I gained every pound back over the course of about ten years. I am still in much better shape than I was before I started the "program" since I have continued exercising all this time. I am also healthy by every measure the medical community can come up with (except, of course, for BMI).

In any case, think what you want about me, but I do know what I'm talking about when it comes to losing weight. I've got an encyclopedia of nutrition information in my brain from my dieting years, and I'm gradually trying to replace it with things I actually enjoy thinking about.

jen said...

I didn't mean to be condescending. I actually think we're kind of on the same page. I know Jenny Craig, weight watchers and low-cal/low-fat diets will result in slowly gaining weight back. I guess that's what I was saying. I'm definitely against counting calories and measuring food. Who wants to focus on eating all the time? As far as what I think of you, for all I know, you're really skinny and have a distorted body image...or a fitness model who just likes to blog about fat. I, myself, had struggled with my weight all of life. I was too skinny and rude people would continually comment on my weight and how terrible I looked and offer suggestions on MY diet. I definitely don't want to be that person to you. This blog seems to invite discussions on weight and diet, but as it is clearly unwelcome I won't do it again. My bad. Anyway, I was finally ordered by a doctor to gain 10 pounds. I ate everything in sight and didn't gain a pound. I had to alter my lifestyle and eat right to gain muscle and weight (ironically, the same formula for losing weight). (I'm still unhealthy according to BMI, of course). Now I get comments about how I look great and can "afford to splurge just this once" and "one piece of pizza won't hurt." Same idiots butting into my life, different focus. So it's not just "fat" people that have to deal with body image and society's view of it. I wasn't suggesting that you lose weight or that you don't understand nutrition. I was just replying to your comment that there is not a healthy way to lose weight and keep it off. (I'm over 40, by the way...since you mentioned a slowing metabolism).

Mary said...

I appreciate your apology, Jen. I guess the thing is that I don't see a huge difference between the "lifestyle change" you recommended (and I always see "lifestyle change" as code for "diet" since when you get right down to it, that's what it is). Eating more lean proteins, less sugar, smaller portions, etc., these will all result in lowering calorie and fat intake, even if you don't advocate "counting" calories and fat. Either way, as you have figured out, on this blog I don't promote any kind of dieting (even if it's called "lifestyle change"). I truly believe that dieting just doesn't work. There has got to be a reason why 95% of people who lose a significant amount of weight gain it back within 5 years, and that reason cannot be that 95% of people just happen to be doing it wrong.

I also have to object to the idea that thin people suffer just as much as fat people do from our society's prescribed body ideal. It sounds like you have had your share of hassles, and people butting their noses into your eating habits when it's none of their business. And I'm sorry you have had to deal with that. But being "too thin" (some people deny there is any such thing) is not at all the same kind of thing as being "too fat".

jen said...

Hmmm...I thought your blog was about erasing stereotypes and prejudice based on weight. I guess hypocrisy comes in all sizes. I won't return so don't bother responding.

Mary said...

Yes, it is, although I think I make it pretty obvious that I'm focusing on fat acceptance. But I don't see how anything I said is anti-thin or perpetuates a stereotype about weight.

If you're reacting to my comment that some people deny that there's such a thing as being too thin, I should clarify that I wasn't saying that *I* am one of those people, and I'm sorry if I didn't make that clear. I was just pointing out that thin is privileged in our society. As I already said, I don't think it's right to harrass anyone about their lifestyle based on a judgment about their body type, fat or thin. But if you truly believe that thin people suffer just as much as fat people do from our society's prescribed body ideal, I think that's more than a little naive.