Monday, 31 December 2018

Swap Your Resolution for a Revolution

The world is messed up you are fineWe have reached another of the Dieting Axis of Evil days – New Year’s. Where we are inundated with messages insisting that it’s in our best interest to resolve to diet, again. The Underpants Rule is very clear on this – people are allowed to do whatever they want with their bodies and that includes attempting to manipulate their size and shape because they think it will improve their health, or that it will stop bullying and stigmatization, or for whatever reason.

People are also allowed to choose NOT to try to lose weight for whatever reason we want – whether it’s because we believe that the research shows behavior, not body size, give us the best chance for health (knowing that health is not an obligation, barometer of worthiness, or entirely within our control), or because we believe that bullying and social stigma should be solved by ending bullying and social stigma, not by giving the bullies our lunch money, or because we believe the evidence about the near-complete futility of intentional weight loss. But this time of year that group doesn’t find much support.

I get a lot of e-mails for people this time of year asking “If I’m not making a weight loss resolution, what resolution can I make?”

I’m glad you asked!

Instead of a New Years Resolution, we can make a New Year’s Revolution.  There is no doubt that we live in a culture that was created around the idea that there is there is only one standard of beauty, and that it requires digital retouching and photo illustration to achieve it.  There is so much pressure to buy into this culture where the beauty and diet industries make billions by convincing us that we are not good enough, and probably never will be, that just waking up and not hating ourselves is an act of revolution, and that’s a pretty good place to start!

With that in mind, here are some ideas to create your own New Year’s Revolution (as always, these are just suggestions,  your mileage may vary and feel free to change any of these to make them work for you.)

  • Resolve to make your first thought of every day one of gratitude for your body, maybe put a note on your ceiling that reminds you to start each day saying something like “You’re a great body and I really appreciate you” (if you need a little help finding the love, this might help.)
  • Create a little mantra to say to yourself (or, hey, out loud if you want to) every time you hear a message that’s meant to make you feel bad about yourself so that you buy a product.  My personal mantra is “Hey, that’s BULLSHIT!” but you create one that works for you (and feel free to share it in the comments if you’d like.)
  • Resolve to stop participating in negative body talk – about other people and your own body.  Start with what comes out of your own brain/mouth (when you start to have a negative thought or utterance, replace it with something positive), and then consider the conversations that you are part of. Maybe when others start body snarking you just walk away, or maybe you say “I wish we could live in a world where we saw the beauty in everyone and didn’t try to tear other people down,” or maybe you say “I made a New Year’s Revolution to stop negative body talk, I’m just not interested in being part of a toxic culture any more.”
  • Resolve to do one piece of activism every week (or day, or month, or whatever) it could be something as simple as posting something body positive to your social media, or interrupting negative body talk, or writing an e-mail to a company that is using the creation of self-loathing as a marketing tactic, or sending a thank you letter to someone who supports you on your journey to size acceptance, or posting a body positive comment to a body negative space online.
  • Resolve to reach out and join/create community – join/create a body positive club at your school or work, join/create a body positive meet-up or Facebook group, subscribe to blogs/tumblrs/instagrams etc. that support your goals
  • If you are choosing health goals, consider making them about behaviors, consider making them additive (an extra glass of water, or serving of vegetables, or hour of sleep a night) rather than choosing “never to do/eat/be [whatever] again”.
  • Resolve to cut yourself some slack if you aren’t able to do these goals 100% of the time. We’re pushing back against a tremendous amount of time, money, and energy that is invested in convincing us to buy into a culture where self-loathing is the norm, and where we see buying diet and beauty products as our only way out. So if we slip back into this mentality it’s not a big shock – I think that the best thing we can do when it happens is to recognize it and move on.

The diet and beauty industry machine that oppresses us runs on our time, energy, and money.  When we take the fuel away, the machine ceases to run.  That’s going to happen, but it’s going to take some time.  For now we can help change the whole world by changing our world, and staging a personal New Year’s Revolution.

Did you like this post? If you appreciate the work I do, you can support my ability to do more of it with a one-time contribution or by becoming a member.

Like this blog?  Here’s more cool stuff:

The New Year Sale is on! – Give the gift of body love and/or get your own year off to a Size Acceptance and Health at Every Size start with discounts on books, online programs, and DVDs to get your year (or the year of the people you’re gifting them to) off to a great start, and save you some money! (Dances With Fat Members get even bigger discounts, so make sure to use your link on the member page.)

Wellness for All Bodies ProgramA simple, step-by-step, super efficient guide to setting and reaching your health goals from a weight-neutral perspective.  This program can be used by individuals, or by groups, including as a workplace wellness program!
Price: $25.00 ($10 for DancesWithFat members – register on the member page)

Non-Members click here for all the details and to register!

Book and Dance Class Sale!  I’m on a journey to complete an IRONMAN triathlon, and I’m having a sale on all my books, DVDs, and digital downloads to help pay for it. You get books and dance classes, I get spandex clothes and bike parts. Everybody wins! If you want, you can check it out here!

Book Me!  I’d love to speak to your organization. You can get more information here or just e-mail me at ragen at danceswithfat dot org!

I’m (still!) training for an IRONMAN! You can follow my journey at www.IronFat.com or on Instagram.

If you are uncomfortable with my offering things for sale on this site, you are invited to check out this post.

Published by danceswithfat

Hi, I’m Ragen Chastain. Speaker, Writer, Dancer, Choreographer, Marathoner, Soon to be IRONMAN, Activist, Fat Person.



via Dances With Fat http://bit.ly/2BQgiV3

Sunday, 30 December 2018

The Short Term Weight Loss Lie

Success and DietsThe vast majority of people who attempt intentional weight loss end up gaining the weight back in a few years, with many gaining back more than they lost. So if we know this, why is weight loss still being sold by everyone from doctors to the government to that annoying person in every Facebook group pushing shakes or whatever? It can often come down to very poorly drawn “scientific” conclusions, and the complete lack of ethics in the diet industry.

The fact is that most people are able to lose some weight over a short amount of time. The problem is the two conclusions that are drawn from that, which then form the foundation for diet culture.

The first is that if it’s possible to lose a little weight, then it must be possible to lose any amount of weight. The second is that if short-term weight loss is possible for almost everyone, then maintaining weight loss must be possible for almost everyone.

These conclusions are total crap. They simply cannot be logically drawn from the facts. They are hypotheses that are disproven by the evidence. It’s embarrassing that so many doctors are still peddling this BS. They, too have been duped by (and/or are profiting from) weight loss and diet culture, very profitably perpetuated by the diet industry, currently worth $66 Billion a year, up from $55 Billion in 2007. (If their product actually worked, their profits would go down over a decade of people getting and staying thin, so the constant increase in profits is a good sign that this is a scam on a massive scale.)

The diet industry has also made a habit of funding studies that only last for two years. A common outcome is that people who stay in the study lose 10 pounds in the first year, they gain back 5 of those pounds in the second year.

The study then stops, they make no attempt to figure out what happened to the people who quit (could it be that they weren’t losing weight?) and the diet industry claims that the majority of participants (meaning the majority of people who didn’t quit the study) ended below their starting weight after two years, which they often call “long-term success.” Of course two years isn’t really long-term anything, and they are conveniently ignoring the fact that the research that goes beyond 2 years finds that the trajectory of weight gain continues, and that most people gain it all back within about 5 years, with many gaining back more than they lost.

For a visual interpretation:
weight loss - studies and truth

Once again, what the research shows is that almost everyone can lose some weight short term. Almost everyone gains the weight back in 2-5 years. Knowing this, the diet industry claims “well, they go back to their old habits…” which is true only to the extent that they go back to not giving their body less calories than it needs to survive in the hopes that it will consume itself and become smaller. When people are talking about an intentional weight loss attempt and they say “it’s not a diet, it’s a lifestyle change” what they mean is “It’s a change to a lifestyle where you diet all the time.” Starvation is not sustainable.

There is nothing wrong with being fat, but even if someone thinks a large body is a problem, an intentional weight loss attempt is the absolute worst thing that they could do (and worst advice we could give them,) since it results in weight gain the majority of the time. For the research around this, I highly recommend Linda Bacon and Lucy Aprhramor’s Weight Science: Evaluating the Evidence for a Paradigm Shift.

We have to start telling the truth about weight and health or we risk coming to the end of our lives to find that we were so busy in the near impossible pursuit of a thin body (and lining the pockets of the diet industry in the process,) that we never took the time to truly live. I don’t know about you, but I wasted years trying to manipulate my body based on stereotypes of beauty and lies about health. No more. I live a full life in the body that I have. Getting off the diet roller coaster is always an option.

Did you like this post? If you appreciate the work I do, you can support my ability to do more of it with a one-time contribution or by becoming a member.

Like this blog?  Here’s more cool stuff:

The End of Year Sale is on! – Give the gift of body love and/or get your own year off to a Size Acceptance and Health at Every Size start with discounts on books, online programs, and DVDs to get your year (or the year of the people you’re gifting them to) off to a great start, and save you some money! (Dances With Fat Members get even bigger discounts, so make sure to use your link on the member page.)

Wellness for All Bodies ProgramA simple, step-by-step, super efficient guide to setting and reaching your health goals from a weight-neutral perspective.  This program can be used by individuals, or by groups, including as a workplace wellness program!
Price: $25.00 ($10 for DancesWithFat members – register on the member page)

Non-Members click here for all the details and to register!

Book and Dance Class Sale!  I’m on a journey to complete an IRONMAN triathlon, and I’m having a sale on all my books, DVDs, and digital downloads to help pay for it. You get books and dance classes, I get spandex clothes and bike parts. Everybody wins! If you want, you can check it out here!

Book Me!  I’d love to speak to your organization. You can get more information here or just e-mail me at ragen at danceswithfat dot org!

I’m (still!) training for an IRONMAN! You can follow my journey at www.IronFat.com or on Instagram.

If you are uncomfortable with my offering things for sale on this site, you are invited to check out this post.

 



via Dances With Fat http://bit.ly/2EUsozD

Friday, 28 December 2018

The Diet Industry- Your Drunk, Booty Calling Ex

Diet Industry booty callAh The Diet Industry. It promised you the world. And it was always good to you in the beginning, but over time it just couldn’t keep its promises, and you would break up. Then it would lure you back, convincing you it was responsible for everything good in your life, you would try again and then have to kick it out of your apartment when it went back to its old failing ways.

You would think you were done for good, but it would come back,  convincing you that you were to blame for the failed relationship and that you just needed to try harder – and you would give it another chance, only to have your heart broken again.

Then you started talking to the Diet Industry’s other exes and you learned that this was the pattern with almost every single one of them. Finally, you dumped the Diet Industry for good.

But the New Year is approaching and here’s the Diet Industry drunk and crying, calling, texting, e-mailing, sliding into your DMs, trying to convince you that it has changed (Now it’s going by its initials instead of its name! It’s a whole new person!) and it can give you everything you ever wanted if you just come back baby, please, just one more chance.

But the Diet Industry is lying – just like it always has – and, deep down, you know it. So remember that you can ignore that call, delete that text, block your shitty ex and keep living the amazing life that you can only live when the Diet Industry isn’t a part of it.

Did you like this post? If you appreciate the work I do, you can support my ability to do more of it with a one-time contribution or by becoming a member.

Like this blog?  Here’s more cool stuff:

The End of Year Sale is on! – Give the gift of body love and/or get your own year off to a Size Acceptance and Health at Every Size start with discounts on books, online programs, and DVDs to get your year (or the year of the people you’re gifting them to) off to a great start, and save you some money! (Dances With Fat Members get even bigger discounts, so make sure to use your link on the member page.)

Wellness for All Bodies ProgramA simple, step-by-step, super efficient guide to setting and reaching your health goals from a weight-neutral perspective.  This program can be used by individuals, or by groups, including as a workplace wellness program!
Price: $25.00 ($10 for DancesWithFat members – register on the member page)

Non-Members click here for all the details and to register!

Book and Dance Class Sale!  I’m on a journey to complete an IRONMAN triathlon, and I’m having a sale on all my books, DVDs, and digital downloads to help pay for it. You get books and dance classes, I get spandex clothes and bike parts. Everybody wins! If you want, you can check it out here!

Book Me!  I’d love to speak to your organization. You can get more information here or just e-mail me at ragen at danceswithfat dot org!

I’m (still!) training for an IRONMAN! You can follow my journey at www.IronFat.com or on Instagram.

If you are uncomfortable with my offering things for sale on this site, you are invited to check out this post.



via Dances With Fat http://bit.ly/2CEAk6D

Thursday, 27 December 2018

External Cephalic Version after Prior Cesarean - 2018 study


People whose babies are breech and have a history of a prior cesarean are often told that External Cephalic Version (ECV), manually encouraging the baby to turn head-down, is simply not a choice for them. The fear is that manipulation done during an ECV might make the uterus rupture along the scar from the prior cesarean.
We have discussed ECV after a Prior Cesarean extensively before. The results of all the studies so far suggest that ECV after prior CS is not unduly risky and can avoid many unnecessary repeat cesareans. ECV should be offered to women at term with a breech presentation, regardless of prior cesarean status. Unfortunately, ECV is woefully underutilized. One study from New Zealand estimated that only 26% of eligible patients with breech presentations were referred for ECV.

2018 Study

Recently, a new study (Impey 2018) was published that looks again at the question of ECV after prior cesarean (CS). Its results were both encouraging and disappointing.

In this new U.K. study, researchers looked back retrospectively over a 16 year period and found 100 cases where babies of women with a prior cesarean presented breech at term, were offered, and consented to a ECV.

Basically, the study found about a 50% rate of success in turning the baby head-down. Those who had head-down babies afterwards had a trial of labor after cesarean (TOLAC), and 68% had a VBAC.

The authors did a literature search on ECV after prior CS and found no increased rate of uterine rupture after ECV. That agrees with the literature search we did.

However, the authors chose to dilute this good news by pointing out that while ECV avoided some cesareans, only 30 women out of the 100 original group had a VBAC. In other words, while they found the practice safe, the way they word the abstract made it sound like instituting a practice of ECV after prior cesarean is not worth pursuing because it is only marginally successful.

This flies in the face of previous research. The big question is why their ECV success rate was so low. Only 50% of their ECV tries worked to turn the baby head-down. That reduced their candidates for TOLAC by half, and then only about 2/3 of these women had a VBAC. That's why the final numbers were low.

If you look at comparable studies, Weill 2016 had a 74% ECV success rate, while Burgos 2014 had a 67% ECV success rate. Why were their results so much better? That's what the UK study authors should be asking themselves. Seems like they need training on how to do ECV more successfully.

Summary

The good news from the study is that External Cephalic Version after a prior cesarean is safe. There are potential risks inherent to the procedure, of course, but these risks do not appear to be any greater in women with prior cesarean than in those without a prior cesarean. And of course, the alternative of an automatic repeat cesarean with a breech carries its own potential risks that also must be considered. The choice should be up to the mother.

The bad news from the study is how few women with prior cesareans are being offered ECV and how low the ECV success rate was. It took 16 years in the study to find a data pool of 100 women who had a prior cesarean and a breech presentation at term who were offered an external version and who accepted it. ECV is tremendously underused, especially in those with a prior cesarean. And a ECV success rate of only 50% is pitiful. Better training is obviously needed.

External Cephalic Version at term can avoid many unnecessary cesareans, yet it is woefully underused in many institutions. It is a reasonable choice that needs to be expanded, especially in women with prior cesareans. Furthermore, training to achieve greater ECV success rates in more places needs to occur.



References

Eur J Obstet Gynecol Reprod Biol. 2018 Dec;231:210-213. doi: 10.1016/j.ejogrb.2018.10.036. Epub 2018 Oct 22. External cephalic version after previous cesarean section: A cohort study of 100 consecutive attempts. Impey ORE, Greenwood CEL, Impey LWM. PMID: 30412904
OBJECTIVE: External cephalic version is commonly not performed in women with a previous cesarean section. Fear of uterine rupture and cesarean section in labor are prominent. The risks, however, of these are unclear. This study aims to document the safety and efficacy of external cephalic version in women with a prior cesarean section in a series of 100 consecutive attempts, and to perform a literature of the existing literature. STUDY DESIGN: This is a retrospective cohort study of prospectively collected data of external cephalic version attempts in women at term with a previous cesarean section, and a literature review of previously published series. External cephalic version was performed by one of 3 experienced operators, with salbutamol tocolysis if appropriate, using ultrasound to visualize the fetal heart and place of fetal parts. RESULTS: 100 women with a prior cesarean section underwent external cephalic version over a 16-year period in one institution. 68% had no previous vaginal delivery. The external cephalic version success rate was 50%, and 30 (63.8%) of these subsequently delivered vaginally. There were no cases of uterine rupture or other complications. A literature review of series containing a total of 549 cases revealed no cases of uterine rupture or perinatal death. CONCLUSIONS: External cephalic version in women with a prior cesarean section is safe but enables a vaginal birth in only about a third of women.
Aust N Z J Obstet Gynaecol. 2016 Sep 14. doi: 10.1111/ajo.12527. [Epub ahead of print] The efficacy and safety of external cephalic version after a previous caesarean delivery. Weill Y, Pollack RN. PMID: 27624629
BACKGROUND: External cephalic version (ECV) in the presence of a uterine scar is still considered a relative contraindication despite encouraging studies of the efficacy and safety of this procedure. We present our experience with this patient population, which is the largest cohort published to date. AIMS: To evaluate the efficacy and safety of ECV in the setting of a prior caesarean delivery. MATERIALS AND METHODS: A total of 158 patients with a fetus presenting as breech, who had an unscarred uterus, had an ECV performed. Similarly, 158 patients with a fetus presenting as breech, and who had undergone a prior caesarean delivery also underwent an ECV. Outcomes were compared. RESULTS: ECV was successfully performed in 136/158 (86.1%) patients in the control group. Of these patients, 6/136 (4.4%) delivered by caesarean delivery. In the study group, 117/158 (74.1%) patients had a successful ECV performed. Of these patients, 12/117 (10.3%) delivered by caesarean delivery. There were no significant complications in either of the groups. CONCLUSIONS: ECV may be successfully performed in patients with a previous caesarean delivery. It is associated with a high success rate, and is not associated with an increase in complications.
BJOG. 2014 Jan;121(2):230-5; discussion 235. doi: 10.1111/1471-0528.12487. Epub 2013 Nov 19. Is external cephalic version at term contraindicated in previous caesarean section? A prospective comparative cohort study. Burgos J, Cobos P, Rodríguez L, Osuna C, Centeno MM, Martínez-Astorquiza T, Fernández-Llebrez L. PMID: 24245964
OBJECTIVE: To determine if external cephalic version (ECV) can be performed with safety and efficacy in women with previous caesarean section. DESIGN: Prospective comparative cohort study. SETTING: Cruces University Hospital (Spain). POPULATION: Single pregnancy with breech presentation at term. METHODS: We compared 70 ECV performed in women with previous caesarean section with 387 ECV performed in multiparous women (March 2002 to June 2012). MAIN OUTCOME MEASURES: Success rate, complications of the ECV and caesarean section rate. RESULTS: The success rate of ECV in women after previous caesarean section was 67.1% versus 66.1% in multiparous women (P = 0.87). The logistic regression analysis confirmed this result (odds ratio 0.93, 95% CI 0.52-1.68; P = 0.82) adjusted by the variables associated with success of ECV. There were no complications in the previous caesarean section cohort. The vaginal delivery rate in the previous caesarean section cohort was 52.8% versus 74.9% in the multiparous cohort (P < 0.01). There were no cases of uterine rupture. CONCLUSION: Based on our data, we conclude that complications are uncommon with ECV in women with previous caesarean section, with a success rate comparable to that of multiparous women. Uterine scar should not be considered a contraindication and ECV should be offered to women with previous caesarean section with breech presentation at term.
Click here for older references on ECV after CS.


via The Well-Rounded Mama http://bit.ly/2CDujqT

Friday, 21 December 2018

Setting Boundaries – In Song!

Cuddlebug McnopeOne of the most frequent questions I get during the holidays is about how to deal with people – especially family – who are behaving badly: food policing, fat shaming, diet and weight loss talking and more.

For me the secret is boundaries. I think it’s best to start by deciding what constitutes behavior that you will put up with. If it’s anything other than “anything goes” then I would consider setting some boundaries with consequences that you can follow through with. So, for example “It is not ok to talk about my weight or eating. If anyone says one more thing about my weight or eating I’m going to leave and we’ll try this again next year.” and then, if they fail to respect your boundaries, it’s time to invoke the consequences.

I’ve done this, and I’ve heard from a number of people who have done this and the common thread seems to be that we only had to do it one time and then our families started respecting their boundaries. Of course your mileage may vary. I’ve written about dealing with the Family and Friends Food Police and Combating Holiday Weight Shame, but in another danceswithfat annual tradition, today we’re going to do this in song.

I’ve re-written the lyrics to “Oh Christmas Tree” to be an ode to boundary setting.

Note 1: In order for this to work, it helps to pronounce boundaries as a three syllable word (BOUND-ah-rees) I also play with the rhythms within the phrases (I had what felt like 27 semesters of music theory in college, this is what I’m doing with it.) If this is an affront to your sense of poetic license I completely understand, I’ll be back soon with a post sans song.

Note 2: At the bottom you’ll find two amazing renditions of this song by Jeanette DePatie and Nadja. Please also feel free to add your own verses in the comments, and/or post a video with your own rendition and it will become a part of this annual tradition.

And with that I give you:

Oh Boundaries (to the tune of Oh Christmas Tree)

Oh Boundaries! Oh Boundaries! You help me deal with family.

Don’t talk about my weight or food.
Why can’t you see it’s hella rude?

Oh Boundaries! Oh Boundaries! You help me deal with family.

You know I love my family
But I will leave if you fat-shame me.

Oh Boundaries! Oh Boundaries! You help me deal with family.

My body’s fine, I don’t need your rants
You’re not the boss of my underpants

Oh Boundaries! Oh Boundaries! You help me deal with family.

Don’t say a word to my fat kid
Or I’ll leave so fast, my tires will skid

Oh Boundaries! Oh Boundaries! You help me deal with family.

Yes I do “need” that second plate
It’s not your business what I ate

Oh Boundaries! Oh Boundaries! You help me deal with family.

Quit saying someday I’ll get sick
Last time I checked you were not psychic

Oh Boundaries! Oh Boundaries! You help me deal with family.

The holidays are great family time
If you don’t shame, food-police or whine

Oh Boundaries! Oh Boundaries! You help me deal with family.

Two Readers (so far – hint, hint) have taken up the challenge of recording this piece, enjoy!

Jeanette DePatie gave us an amazing opera/jazz rendition:

and Nadja killed it a capella in the middle of the night in her PJs:

Did you like this post? If you appreciate the work I do, you can support my ability to do more of it with a one-time contribution or by becoming a member.

Like this blog?  Here’s more cool stuff:

The Bundle Up! Sale is on! – Give the gift of body love and/or get your own year off to a Size Acceptance and Health at Every Size start with bundles that include books, online programs, and DVDs to get your year (or the year of the people you’re gifting them to) off to a great start, and save you some money! (Members get even bigger discounts, so make sure to use your link on the member page.)

Wellness for All Bodies ProgramA simple, step-by-step, super efficient guide to setting and reaching your health goals from a weight-neutral perspective.  This program can be used by individuals, or by groups, including as a workplace wellness program!
Price: $25.00 ($10 for DancesWithFat members – register on the member page)

Non-Members click here for all the details and to register!

Book and Dance Class Sale!  I’m on a journey to complete an IRONMAN triathlon, and I’m having a sale on all my books, DVDs, and digital downloads to help pay for it. You get books and dance classes, I get spandex clothes and bike parts. Everybody wins! If you want, you can check it out here!

Book Me!  I’d love to speak to your organization. You can get more information here or just e-mail me at ragen at danceswithfat dot org!

I’m (still!) training for an IRONMAN! You can follow my journey at www.IronFat.com or on Instagram.

If you are uncomfortable with my offering things for sale on this site, you are invited to check out this post.



via Dances With Fat http://bit.ly/2RhRQG9

Thursday, 20 December 2018

HAES Heroes: Joanne Ikeda

Joanne Pakel Ikeda
This post is to remember and honor one of our Health At Every Size® heroes.

Joanne Pakel Ikeda died on November 27, 2018 at age 74. She was a faculty member of the Nutritional Sciences Department at the University of California, Berkeley, for nearly 35 years. She helped students gain knowledge and skills in nutrition education and counseling.

She was well-known for her advocacy for the Health At Every Size model. In fact, she and Frances Berg coined the phrase. From her obituary:
Joanne was known for her role in the development of a new approach to weight management entitled Health at Every Size® (HAES). Mid-career she came to the conclusion that subjecting large people to food restriction, body dissatisfaction, and size discrimination was futile and only resulted in physical, psychological and social damage to these individuals. She and others determined that rather than focus on weight, the focus needed to be on health. Research showed that many large people could improve all aspects of health with lifestyle modifications unaccompanied by weight loss.
The idea to focus on health instead of weight was a radical, transformative notion in the field of nutrition and medicine and turned the field on its ear. While it has gained a great deal of traction, HAES sadly remains radical to many in those fields, but she never backed down. She was especially determined to protect children from becoming casualties in the “war on obesity” by promoting a Health at Every Size approach for them instead. Here is one of the posters she lent her support to.


Joanne fought hard for size acceptance for all ages and spoke at many conferences and other occasions about Health At Every Size. She worked with NAAFA (National Association for Fat Acceptance), which is where I met her. She helped establish ASDAH, the Association for Size Diversity and Health. She backed up her beliefs with action by testifying before the San Francisco Board of Supervisors about an ordinance banning size discrimination in employment, housing, adoptions, jury selection and other domains. That took guts.

Joanne did not just specialize in weight-related issues. She also studied the nutritional habits of various ethnic groups, immigrants, and low-income people in California and developed culturally sensitive nutrition education materials. She was a visionary in her field in many ways.

She accrued so many honors, I will only list a few here. She served as President of the California Academy of Nutrition and Dietetics, then was elected President of the Society for Nutrition Education and Behavior. She was co-founder of the UC Berkeley Center for Weight and Health. In 2018 she received the Helen Denning Ullrich Award for Lifetime Excellence in Nutrition Education.

I had the honor and pleasure of hearing Joanne speak in person and getting to chat with her afterwards. She was a warm, unassuming person, but she also knew her research and her points were evidence-based. She was very modest and humble but she also knew how to make a vehement rhetorical point when needed and wasn't hesitant to call out medical professionals on their assumptions and errors. She gave me lots of warmth and encouragement for my work on pregnancy in women of size, which was much appreciated as pregnancy is very much an overlooked area in HAES and size acceptance. As a parent, I particularly appreciated her advocacy for higher weight children in the midst of virulent anti-obesity public health campaigns.

Joanne Ikeda was a god-send to the size acceptance community and people of size, and we will sorely miss her presence and influence. Our hearts go out to her family and friends.



Resources

Obituary: https://www.legacy.com/obituaries/sfgate/obituary.aspx?n=joanne-ikeda&pid=190873802

Articles:



via The Well-Rounded Mama http://bit.ly/2QJNGax

Tuesday, 18 December 2018

Are You Accidentally Ruining the Holidays for Fat Friends and Family?

Talking NonsenseI spend a lot of time helping fat people deal with the bullshit fat shaming that comes our way daily, and that often escalates at the holidays (whether we celebrate them or not.)  I try to be clear that these things are not our fault, even though they become our problem and that the problem isn’t fat people, it’s fat shaming. So today I wanted to take a second to talk directly to on purpose fat shamers, accidental fat shamers, and potential fat shamers – however well-meaning they may be – about how they can stop the problem before it even starts at the holidays, and all year long!

Don’t give a weight loss or “health” gift

Don’t give a gym membership, diet club membership, “healthy meal” delivery etc. unless the person has very specifically asked for it.  Including and especially if you’re only assuming that they don’t already do or have these things because of your stereotypes about fat people, or as a passive-aggressive hint that you think they may “need” the gift. Instead, if you want to give a gift, consider choosing something based on the person’s actual likes and interests rather than stereotypes and fat shaming. Or maybe a nice gift certificate.

Don’t be the food police

Don’t monitor, comment on, or concern yourself in any way with fat people’s (or any sized people’s) food choices at parties, holiday dinners or, hey, ever.  If we need the food police, we’ll call Pie-1-1. If you feel like you might have to deal with the Family and Friends Food Police, here are some tips.  If you want some ideas to help when you see this kind of food shaming, check here.

Don’t give a fat-shaming card

Way too many fat people get cards with some version of  “We love you and we want you to lose weight because we want you to be around a long time.” If you honestly can’t figure out why “Happy Holidays! Please don’t die of fat because mourning you would be a major bummer for us” isn’t an appropriate message for a holiday card, then please just take my word for it this is a bad idea. And also, consider that giving cards may not be for you. The person to whom you deliver this little Hallmark moment may be able to defend themselves in court successfully with “Your Honor, they needed a killin’” This happened to my partner a few years ago and we chose to cut ties with the relatives completely, about which it seems they are upset. Bad behavior can have undesired consequences for everyone, don’t put your fat friends and family in this position.

Don’t engage in diet talk or negative body talk

This suggestion isn’t just to help fat guests, but also for guests of any size who may be dealing with eating disorders, or guests who are interested in conversations that aren’t boring as hell. Find something else to talk about than why you are or are not eating what you are or are not eating.  Skip the 5 minute soliloquy on what you feel you have to do to punish yourself for eating pie, and ask somebody at the party to tell you about themselves instead, or go watch TV, or play on your phone, whatever.

Don’t comment on body size changes

Nothing says “Happy Holidays” like knowing that your relatives are monitoring your body. You might think it’s a compliment to ask if someone has lost weight but that question is super loaded – perhaps they’ve lost weight because of illness, grief, medication, an eating disorder, or something else unwanted or unintentional. Perhaps they are uncomfortable with having their body size made into a topic for discussion (maybe because it’s hella inappropriate…) Perhaps they haven’t lost weight and, however well-intentioned you may be, they take it as backhanded or passive-aggressive. (Or perhaps you intended it to be backhanded or passive-aggressive in which case you’re being an ass,  won’t you please be a dear, and knock that shit off.)  If you want some suggestions for wading through the tricky world of weight loss compliments (like what to do when someone tells you’ve they’ve lost weight and then looks at you expectantly), you’ll find that here.

Don’t stage some kind of weight loss intervention

This should be a big pile of obvious in an obvious box with an obvious bow, but every year some asshat who wants to be thought of as “brave” writes an article about how the holidays are the perfect time to fat shame your relatives “for their own good.” First of all, people’s weight and health (two different things) aren’t your business unless they ask you to make them your business. Even if you don’t believe that, the holidays are definitely not the time to do this.  And if you feel that you have to do this at the holidays because it’s the only time you see that person, then consider how relevant you really are in their lives and whether you have any business doing this at all.  Then don’t. Just don’t. Do Not. Don’t. Trust me when I tell you, you are not The Fat Person Whisperer.

Did you like this post? If you apprecieate the work I do, you can support my ability to do more of it with a one-time contribution or by becoming a member.

Like this blog?  Here’s more cool stuff:

The Bundle Up! Sale is on! – Give the gift of body love and/or get your own year off to a Size Acceptance and Health at Every Size start with bundles that include books, online programs, and DVDs to get your year (or the year of the people you’re gifting them to) off to a great start, and save you some money! (Members get even bigger discounts, so make sure to use your link on the member page.)

Wellness for All Bodies ProgramA simple, step-by-step, super efficient guide to setting and reaching your health goals from a weight-neutral perspective.  This program can be used by individuals, or by groups, including as a workplace wellness program!
Price: $25.00 ($10 for DancesWithFat members – register on the member page)

Non-Members click here for all the details and to register!

Book and Dance Class Sale!  I’m on a journey to complete an IRONMAN triathlon, and I’m having a sale on all my books, DVDs, and digital downloads to help pay for it. You get books and dance classes, I get spandex clothes and bike parts. Everybody wins! If you want, you can check it out here!

Book Me!  I’d love to speak to your organization. You can get more information here or just e-mail me at ragen at danceswithfat dot org!

I’m (still!) training for an IRONMAN! You can follow my journey at www.IronFat.com or on Instagram.

If you are uncomfortable with my offering things for sale on this site, you are invited to check out this post.



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Monday, 17 December 2018

Adorable Dogs Teach Us How To Beat Holiday Food-Shaming

As some people are celebrating holidays that include things like chocolate, candy, and feasts, I am seeing a ton of food shaming, food policing, and food moralizing.  All of this is crap, for the reasons I explain here, but I thought what I would do today is give you some options for response. Note, today’s responses are in pictures (mostly starring our adorable dogs – you can click on them to enlarge them) If you are looking for verbal responses, head over here.

Did you like this post? If you apprecieate the work I do, you can support my ability to do more of it with a one-time contribution or by becoming a member.

Like this blog?  Here’s more cool stuff:

The Bundle Up! Sale is on! – Give the gift of body love and/or get your own year off to a Size Acceptance and Health at Every Size start with bundles that include books, online programs, and DVDs to get your year (or the year of the people you’re gifting them to) off to a great start, and save you some money! (Members get even bigger discounts, so make sure to use your link on the member page.)

Wellness for All Bodies ProgramA simple, step-by-step, super efficient guide to setting and reaching your health goals from a weight-neutral perspective.  This program can be used by individuals, or by groups, including as a workplace wellness program!
Price: $25.00 ($10 for DancesWithFat members – register on the member page)

Non-Members click here for all the details and to register!

Book and Dance Class Sale!  I’m on a journey to complete an IRONMAN triathlon, and I’m having a sale on all my books, DVDs, and digital downloads to help pay for it. You get books and dance classes, I get spandex clothes and bike parts. Everybody wins! If you want, you can check it out here!

Book Me!  I’d love to speak to your organization. You can get more information here or just e-mail me at ragen at danceswithfat dot org!

I’m (still!) training for an IRONMAN! You can follow my journey at www.IronFat.com or on Instagram.

If you are uncomfortable with my offering things for sale on this site, you are invited to check out this post.



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Saturday, 8 December 2018

How to Find a Chiropractor in Pregnancy: Part Two


We have been discussing chiropractic care in pregnancy and how it can be helpful towards a more comfortable pregnancy and possibly a more efficient labor and birth.

Many people are interested in seeing a chiropractor, but some know nothing about how to find a good chiropractor for pregnancy.

Basically, all chiropractors receive some training in treating pregnant women, so you could see most chiropractors and get at least some help. However, some chiropractors are more highly trained in pregnancy than others and you are probably better off with those.

Your best bet is to find a chiropractor who is trained in the Webster Technique, which is a specific protocol that looks at the alignment of the sacrum and pelvis and the balancing of soft tissues (muscles, ligaments) around it:
The Webster technique is a specific chiropractic analysis and diversified adjustment. The goal of the adjustment is to reduce the effects of subluxation and/or SI [sacroiliac] joint dysfunction. In so doing neurobiomechanical function in the sacral/pelvic region is improved.
The Webster Technique is not just for pregnant people, but can be applied to any weight-bearing person. However, its focus on relieving restrictions in the pelvis and restoring balance to the soft tissues in the area may be particularly very useful for pregnancy.

Chiropractors who have extra training in working with pregnant people can be found in several ways. There are several chiropractic professional organizations, and they can be a good place to start your search. These organizations are similar in many ways, but may have differences of opinion on certain philosophies or treatments, etc.

International Chiropractic Pediatric Association

The International Chiropractic Pediatric Association (ICPA) has a list of chiropractors who specialize in working with kids and pregnant mothers, or who have completed a training course in Webster's Technique, which addresses the specific needs of the pregnant body.

You can find a pediatric chiropractor with the ICPA at http://icpa4kids.org/Find-a-Chiropractor/.

However, this is not a complete list of all the chiropractors who are certified in the Webster Technique. The chiropractors on this list are ones who have asked to be put on this referral list. There may well be other chiropractors in your area who have been trained in the Webster Technique but did not sign up for this list. You can call the ICPA and ask if there are others in your area trained in the Webster Technique.

According to the ICPA website, the ICPA has created a tiered level of training. The first level is "Webster-Certified," which means extra class time beyond the chiropractic degree specializing in the Webster Technique for pregnancy. It is often the starting point for even more advanced training.

The next level is Pediatric Certification, but there are several levels of this. Some program participants have the initials F.I.C.P.A after their names, and undergo 120 hours of continuing education. Other participants undergo an expanded program of 200 hours and have the initials, C.A.C.C.P., after their names. The highest level of training is the Pediatric Diplomate, which requires 400 hours of continuing education, and these chiropractors have the initials D.A.C.C.P. after their names.


International Chiropractic Association

The International Chiropractic Association (ICA) has a Council on Pediatric Chiropractics. Their focus is on treating children, but their definition of "pediatrics" includes in-utero babies so they treat pregnant women as well. Many of these ICA members have gone on to become Board Certified in chiropractic pediatrics in a 3-year post-graduate course of over 360 hours. These chiropractors have "D.I.C.C.P." after their names as well as "D.C." Look here for lists of those with a DICCP diploma.

The ICA also has a list of members who are trained chiropractors who are interested in and specialize in children, but who may or may not have the further training that a "DICCP" diplomate has. Some of the chiropractors on this list are in the process of working on the DICCP diplomate program but have not finished it yet. Regardless, they may be excellent possibilities as well.

In addition, the ICA can be reached at 1 (800) 423-4690 to ask for referrals in person. Ask for a pediatric chiropractor who knows the Webster Technique. 

Other Possible Sources

Not everyone who is certified in Webster's Technique is going to be on the ICA or ICPA lists, but they are good first places to start looking. If you can't find anyone in your area from these lists, it doesn't mean there is no one to help you. Keep looking; many women who initially think there is no one in their area who can help them do eventually find help. It just may not be from the above sources.

One of the best ways to find a Webster-certified chiropractor is to try calling your local homebirth midwives, childbirth educators, and doulas and asking for a recommendation. Often they are familiar with the healthcare professionals in the area that offer pregnancy-related services and can recommend the best ones to you, saving you a lot of time and trouble.

If you cannot find a chiropractor trained in the Webster Technique in your area, you could consider a chiropractor who has extensive experience with pregnant women. Even basic chiropractic care may help enough to make a difference in your comfort level. But if you have a choice, someone trained in the Webster technique is probably preferable. 

People in countries that don't have chiropractors may want to try an osteopath. Osteopaths also do body manipulation to help align the body and relieve restrictions, although not quite in the same way as chiropractors. However, not all osteopaths do manipulations anymore. You might need to find one who has had classical osteopath training.

In some areas, chiropractors can be hard to find. If all else fails, try cold-calling all the chiros and/or osteopaths in your area. Ask them:
  • If they have experience and training in treating pregnant women (and what that training might be)
  • How much of their practice is devoted to pregnant women and babies
  • What kind of special equipment they have for accommodating the growing belly of pregnant women
  • If they have been trained in either Webster Technique, the pelvic "diaphragmatic release," or any other technique which might be especially helpful to a pregnant person
  • If they have not been trained in any of these techniques and/or are not experienced with pregnant women, do they know of any chiropractors in the area who are?
Talk to them on the phone if you can and get an idea of how experienced they are and whether they "click" with you. If they sound good, consider trying them for one visit to see how things go. Some chiropractors will do a free consultation so you can visit their practice and check them out. Others might let you observe someone else's treatment (with the patient's permission) so you can see the techniques in action. Ask how many pregnant women the doctor usually sees. Ask for referrals from other patients. Call the midwives in your area and see if they have any experience with that chiropractor.

Remember, all chiropractors are not alike. Some use pretzel adjustments by twisting and turning the patient's body. Some use a drop table to give a little bit of extra force to the adjustment without having to push on the patient as hard. Some use an activator, a spring-loaded small tool that exerts less force for those who dislike traditional adjustments. Some do hands-on work so subtle it's hard to know they are doing anything. There are many, many techniques and styles out there.

Keep your "quackometer" on alert and don't be afraid to try a different chiropractor if one doesn't seem right to you, if the treatment seems unreasonable or ineffective to you, or if they seem too profit-driven. If one chiropractor doesn't work well for you, it doesn't mean that none will. Sometimes it's just a matter of finding the one that fits you and your needs.

If in the end you decide that chiropractic care is not for you, that is a perfectly legitimate choice as well. Many women go through pregnancy without chiropractic care and do just fine. But if you have lots of back pain, pelvic pain, or a history of falls and/or accidents, it may be worth searching a little harder to find the right chiropractor for your needs. 

My Chiropractic Search Story


Although I didn't really experience much significant back problems before pregnancy, once I was pregnant I began to have tremendous back pain, sciatica, and pubic symphysis pain, probably from a series of minor car accidents years before. My care providers shrugged my pain off as a normal part of pregnancy, but by the end of my second pregnancy I could hardly walk at times. This certainly didn't seem normal to me, so I decided to consider a chiropractor.

My search for a chiropractor was long and involved. At the time, there were no lists from the ICA or the ICPA to check, and the local chiros I consulted did not even know about the Webster Technique. I saw several different chiros or osteopaths (D.O.s) over the years, looking for some help. It took a long time to find the right one. 

The first chiro I tried was a sports specialist available through the local family doctor's office. Unfortunately, he was majorly fat-phobic and obviously disgusted by my body. He never physically evaluated my back or pelvis, and he never touched me. He told me that my back pain was because I wasn't getting enough exercise, and gave me some special exercises to do for the muscles in the area. I tried them; they didn't help. I gave up the idea of chiro care for several years.

In my third pregnancy, I stepped up the effort to find some help. None of the doctors or midwives I saw knew of anyone who knew the Webster Technique. I saw an osteopath who had never heard of the Webster Technique, told me my back and pelvis were fine despite all my pain, and was basically no help.

My prenatal yoga teacher in that pregnancy eventually mentioned a chiropractor who used a less forceful "Network" technique for adjustments and who specialized in sacrum pain. I decided that this was better than nothing and saw this chiro. These treatments did not really help much but he happened to know of a young chiropractor in the area who was in the process of getting her DICCP diplomate from the ICA, so he referred me to her.

Amazingly, this chiro had just learned the Webster Technique at a recent class session and was able to help me out. She was shocked at how badly my back and pelvis were out of alignment. My back and pubic symphysis pain improved greatly within an hour or two after treatment. Although we weren't trying to turn the baby with the adjustment, the baby turned from posterior to anterior within an hour after the adjustment, the first time any of my babies had been anterior in three pregnancies. I went on to have a few more appointments in that pregnancy to keep things aligned and fine tune everything. Two weeks later, my baby was born by VBAC, Vaginal Birth After Cesarean.

My third labor and birth was SO much easier than my first two. In my first pregnancy, I had pushed for 2 hours with a malpositioned baby, then had a cesarean. In my second pregnancy, I had pushed for 5 hours with a posterior baby, then had a cesarean. In this pregnancy, I pushed for 12 minutes and the baby was born. He was born so quickly the doctor didn't even make it to the birth; the nurse had to catch the baby. I attribute the relative ease of this birth to the chiropractic care and the fact that the baby had turned to anterior, unlike my previous babies. 

In my fourth pregnancy, I tried an ICPA-trained chiro who was located much closer to home because I was tired of the long drive to my usual chiropractor. The new chiro was perfectly nice and very competent, but she didn't "get" my body and was not able to give much relief. So even though this chiropractor knew the Webster Technique, was very well-trained and knowledgeable, and was certified through the ICPA, she wasn't the right chiropractor for me. 

At one point, I also tried a different osteopath, one with more "classical" manipulation training, and did not find those results as effective either. I eventually went back to a chiropractor trained by my original chiropractor, realizing that a long drive was well worth the trouble to get better results. He focused not only on my back/sacrum, but especially on my pubic symphysis and supporting ligaments because of my pain there, and we found that I tended to respond to that protocol best.

I gave birth to my ten-pound baby (a pound bigger than my cesarean babies) with just 24 minutes of pushing. I'm sure it was not all due to just chiropractic care, but I do believe that a lot of it was. I was glad I had persevered in my chiropractic search.

Summary

Finding a good chiropractor for pregnancy is not always easy. Just as not every OB or midwife is equally effective for everyone, it's important to find a chiropractor that "gets" your body, uses techniques that you find helpful, and is always respectful and responsive to your concerns.

Don't just stop at the first chiro you find, try it once, and then conclude that chiropractic care is not for you. Try out several different styles if you can. If you can't do that, get the advice of local midwives and doulas because they often know the very best people in the area to recommend. Their guidance can save you a lot of time and effort. Remember, just as with an OB or midwife, it's all about finding a provider who is compatible with you.

My own story shows the importance of searching for the practitioner who is right for you. The first chiros and osteopaths I tried were not able to help me. Had the ICA or ICPA lists been available then, my original pregnancy chiro would not have been listed because she was still in the process of training. An ICPA-trained chiro that I tried later looked great on paper but was not effective for me. The chiros I saw saw for the fourth pregnancy were not listed because neither of them is a DICCP diplomate ─ but they were trained by a DICCP diplomate and so were familiar with the techniques needed. The chiropractor that was the closest and most convenient to me did not turn out to be the best chiropractor for my body. It took quite a bit of "shopping around" to find a chiro that worked well for my needs, but in the end it was well worth the work.

There are no easy or quick answers to searching for a good chiropractor for pregnancy. If at first you don't find a Webster Technique chiropractor, keep trying. If the chiro you try at first doesn't seem able to help you or you don't get good results with them, be willing to try others. Good and bad chiros are all over; lists can be a good place to start your search but ultimately they don't tell you much about the quality of the chiropractors themselves.

Nothing substitutes for actually trying something and keeping the search up till you find one that really clicks with your needs.


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