Friday, 26 October 2018

If The Doctor Says A Health Issue is Caused By Being Fat

Doctors telling fat patientsI’m often contacted by someone who has just been diagnosed with a health issue, and their healthcare provider has blamed it on their size and, in most cases, suggested dieting. The person contacting me has been practicing Size Acceptance/Health at Every Size (usually after a lifetime of failed dieting) but they are wondering if maybe they should try dieting again considering this new diagnosis.

Of course I’m not a doctor and I’m not giving medical advice, but I always tell them what I would do. If it were me I would look at it in two parts. First – is it true that body size causes this issue. Second, if so is attempting to control my body size a good healthcare option?

Part 1 – Is it true that body size causes this issue

Determining this can be tricky because our medical system is so steeped in fatphobia that people extrapolate causation from correlation, and extrapolate correlation from nothing (I’ve had doctors prescribe dieting to me for a broken toe, a separated shoulder, and strep throat, so we have to assume that healthcare professionals may be viewing our health through an extremely fatphobic lens. Almost any fat person can tell you that “diagnosis fat/prescription weight loss” is a huge barrier to fat people getting competent healthcare.)

The question that I’ve found to get to the bottom of this is “does this happen to thin people” If the answer is yes (and it always is,) then I know that being thin can neither be a sure preventative nor a sure cure. (If the answer is “yes, but it happens more often in heavier patients” The follow up questions would be “based on what research” and “how much more often are heavier patients tested for this than thinner people.” )

Part 2 – Is attempting to control my body size a good healthcare option?

If I were to decide that my size is causing this issue, the next question would be “is attempting to control my body size a good healthcare option?”

There is not a single study where more than a tiny fraction of people have succeeded at long-term weight loss, and very often these “successes” lost only 5-10 pounds. Almost everyone who attempts to manipulate their body size (through whatever method, whether it’s called a diet or lifestyle change, or something else) ends up gaining back their weight, and the majority gain back more than they lost and end up at a higher weight (that was exactly what my dieting attempts led to)– so if we’re considering body size to be the “problem,” then attempting to manipulate my body size is the worst possible choice based on all the research, and my personal history with dieting. So that would be a no on the weight loss attempt.

I would ask my healthcare provider(s) what thin people are told to do for whatever this health problem is, and I would go from there in terms of choosing a course of action.

I think that doctors telling fat patients to attempt to become thinner (to solve health problems that thinner people also have) is not just lazy healthcare, it’s unethical, unsupported by evidence, incompetent healthcare and, if I can help it, I won’t put up with it.

Did you appreciate this post? If you like 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:

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 training for an IRONMAN! You can follow my journey at www.IronFat.com or on Instagram.

 



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Thursday, 25 October 2018

Remaking Jam That Didn't Gel


I've been preserving and canning food for a while now. I'm no expert but I've had pretty good luck so far with applesauce, chutney, jellies, and all kinds of jams.

Until now.

Yep, I just had a couple of large batches of jam fail spectacularly.

The Backstory

This summer we had a HUGE crop of plums in our yard from just two plum trees. Stupendously big crop. SO. MANY. PLUMS.

We gave plums away, we dried plums, we made plum chutney, we made plum sauce, we made plum pies. And still we had plums coming out our ears.

So we decided to try to make plum jam. This is not a jam I'd ever made before. A friend made me plum jam from a different type of plum a few years ago and I didn't like it at all. Thus, we'd never tried plum jam with our plums...but we were ready to try anything to get rid of all these plums!

So we made a few successful batches of plum jam, and I tried a little on toast one day. WOW. I was so surprised. I loved this plum jam. I think the difference was ours was made with Italian plums which makes a delicious, thick, extremely flavorful jam. I immediately knew I'd be making more.

We finished picking all the rest of the plums...we got like 3-4 big buckets more. So we decided to make several batches of jam, using up the last of the regular pectin (Sure-Jell) in my cupboard. The first batches went well, no problems. The last batch, though, was a full-sugar recipe (which I rarely use because I find it too sweet). But I was out of my preferred pectin, and I'm loathe to waste food. So we winced and made full-sugar plum jam. We thought we followed all the directions correctly, but in the end it never gelled.

So now I had a whole bunch of jars full of plum syrup. This is not something I am likely to use. I have some raspberry syrup from a batch of raspberry jelly that didn't set up a couple of years ago and we are still trying to use it up. Mostly we add it to lemonade to make Raspberry Lemonade, but it doesn't take much so it takes forever to use up. All those jars of Plum Syrup were never going to get used.

So I thought, let's see if we can remake that jam and get it to set up properly.  I'd never done this before so I did a little research and found some articles online.

Keep in mind, the information below is pertinent only to jams with an added pectin like Sure-Jell (either the pink box or the yellow box).

Cooked jam without any added pectin is another story entirely and not covered here; Food in Jars is a good website for that type of jam. Directions for remaking jams with Pomona Pectin can be found on the Pomona Pectin website.

General information about different types of pectins and the pros and cons of each can be found in my article on pectins. This article gets a lot of online traffic so hopefully people are finding it useful.

Why Gelling May Fail



When it comes right down to it, making jams and jellies is really a chemistry experiment. Certain reactions are needed in order to make gelling action happen. Basically you cook up mashed fruit, then add a certain amount of sugar, acid, and pectin in order to make those reactions happen. Get the balance right and you get lovely jam or jelly. Get the percentage wrong and you get a runny mess.

Fruits naturally have some pectin in their cell structures, especially in the skins and seeds. The goal of cooking the fruit is to break down the pectin in the individual fruit so it can then build a mesh with the pectin from other fruits. This makes a gel where fruit bits are suspended in a latticework of pectin.

The problem is that pectin molecules repel each other. Acidity is needed to overcome this and let pectin molecules bond with each other to make the lattice structure. Sugar is needed to bond with the water so the water doesn't overwhelm the pectin. So all of these, heat, sugar, acid, and pectin, are needed in just the right amounts and timing to make jam or jelly.

Here is a quote about the process from a science blog:
The whole chemistry of jam making is all about making this pectin that's in the fruit break down and become water soluble. That then recombines, and all of those hydrogen bonds that are holding it together recombine in a chemical reaction with the fruit acid and with the sugar, and that makes a lovely network that forms a gel, and that's the kind of jelly-like substance of jams. 
So you need to get that chemical reaction right, the pectin amount right, the fruit acid right, and the amount of sugar right so that you make the right consistency of that network that will hold your jelly together, your jam together, so you don't get fruit sauce.
Fruits that are naturally high in pectin and acidity like quince, underripe apples, red currants, cranberries, and gooseberries are an exception. They often don't need anything except cooking in a little water to set up and gel.

Here are a few reasons why an added-pectin jam of most other fruit may fail to set up/gel:
  • Not enough acidity - Some fruits have enough acidity on their own to gel without adding lemon juice, but most fruits need added acidity via lemon juice, lime juice, vinegar, or other acids. If you didn't add enough acid, the fruit won't gel
  • Not enough sugar - Box pectin jam recipes should not be altered. If you use less than the full amount of sugar, the jam will not set up. Therefore, follow the recipe on the box and measure exactly; don't try to make it "healthier" by using less sugar. The recipe depends on that exact amount of sugar. The exception is Pomona Pectin, which uses a type of pectin that doesn't need sugar to activate it; it uses calcium instead. If you want to reduce sugar in jams, use Pomona Pectin, but remember that most jams need at least some sweetener for the sake of taste 
  • Too much water added - Using too much water to cook the fruit can throw off the balance of pectin, acid, and fruit. Use only enough to keep the fruit from burning 
  • Doubling a batch or making too large a batch - Jam batches need to be made one at a time, no more than 4-6 cups of fruit at a time. You can't double a batch and expect it to set up properly. One of the annoying things in jamming is having to make and clean up each batch separately. But that's better than having to throw it all away!
  • You didn't get a hard enough boil - Added pectin needs a hard boil of about a minute in order to activate properly. If you didn't boil the pectin long enough, the gel may fail. If the pan boiling the fruit plus pectin was too deep, then the heating may be uneven, affecting the gel
  • Cooked too long - Some jams turn out runny because they were boiled too long. Overcooking can destroy the ability of the pectin to sustain its structure
  • Using over-ripe fruit - The riper the fruit, the less acid and pectin it contains, and the runnier the resulting jam. If you use very ripe fruit, either add more pectin and acid or add some under-ripe fruit to balance the batch. Another choice can be to add in fruit naturally rich in pectin and acid like the ones listed above if you don't mind the extra flavors in your jam 
  • Pectin too old - Some types of pectin lose their effectiveness if not used within the first year. Pomona Pectin does not have this issue but it's the only one that is reliably long-lasting
  • Leaving the jars in hot water too long - If you put the jars into the canning pot too soon, before the water has boiled, the total exposure to heat may become too much and break down the pectin structure. Likewise, if you leave the jars in the hot water too long afterwards, that can also break down the pectin. After the 10 minute canning time and the 5 minute rest time afterwards in the canning pot, take the jars out immediately and place on a towel on the counter
  • Tipping the jars - Some resources say that tipping the jars to the side as you take them out of the canning pot (or while they are cooling on the counter) can destroy the pectin bonds that are trying to form. Pick jars straight up out of the canner and leave them on the counter. Resist the temptation to tip them and check the set until at least 24 hours have passed 
  • Not waiting long enough - Some jams with some pectins don't set up for a long time, even a week or two. You can always just let them set on the counter and see if the gel improves
Bottom line, if your jam didn't set up, the most likely cause is that you were out of balance with your sugar/acid/pectin, or you didn't cook it for the right amount of time. However, there are a few other nitpicky mistakes that even experienced jammers can make. If you have a significant jam failure, review the list and see if any apply.

Remaking Syrupy Jam



Whatever caused your syrupy jam, don't throw it away. Even very experienced jammers have had batches fail, so they have certain techniques for fixing a failed gel. They don't always work but they are worth a try. The following is the most commonly recommended technique for remaking jam.

First, be sure you have everything you need ready to go ahead of time. This includes a canner full of hot water; funnels, jar-lifters, and ladles clean and ready to go; extra new lids for the jars; and enough extra sugar, pectin, and lemon juice to remake the jam.

Open the lids of the runny jam (these lids cannot be reused for canning). Pour the jam out into a glass measuring cup until it makes a total of 4 cups. Clean the old jars in soapy water and rinse, or use new clean, sterilized jars. 

Mix 1/4 cup sugar, 1/2 cup water, 2 tablespoons bottled lemon juice, and 4 teaspoons powdered pectin. Heat up until it has been brought to a rolling boil. 

Add the 4 cups of syrupy jam. Stir continuously until the whole thing has been brought to a rolling boil. Keep boiling for at least 30 seconds more, but don't overboil. 

Remove from heat, ladle into jars, put on NEW lids, add screwtops, then can in a waterbath canner for 10-15 minutes, depending on the size of the jars. Turn off heat and let jars sit in water for 5 more minutes, then immediately remove jars straight up out of the canner without tipping them. Put them on a towel on your counter overnight.  Don't check or tip them until 24 hours have passed. 

Some people report that chia seeds can be used to thicken up a runny jam, if you are open to that. Personally, I dislike chia seeds so I have never tried this but if you like them it may be worth a try.

Remain Philosophical About Results


Sometimes you can seemingly do everything right and a jam will simply not set up. Who knows what went wrong? All you can do is give it your best shot at redoing it. About half to two-thirds of the time, you can fix a runny jam. Sometimes you never do. Don't be afraid to just give up and call it Syrup at some point. Feel free to pretend that's what you wanted all along. Plenty of cooks before you have done the same!

Don't throw away your results. People use syrupy jam as toppings for pancakes, waffles, ice cream, yogurt, or desserts like poke cake. Our family sometimes adds it to lemonade to make a special drink during the summer. It can also be dehydrated into fruit leather, like above. Or you can add a little corn starch and use it as a glaze for roasted meats. It's surprisingly tasty as a glaze with pork in particular. (If that sounds weird, think about cranberry sauce with turkey at Thanksgiving. Same principle of fruit with savory.)

My first try at remaking syrupy plum jam was a mixed success. Some of it came out perfectly; no problem with the set the second time around.

However, about half of it didn't set again. Oh well. Considering how many batches of plum jam we made, that still left me with a lot more Plum Syrup than I wanted. On the other hand, we saved half the batch. I consider that a win.

I'm not quite sure why some batches failed in the original jam. My guess is we got sloppy in our measuring because of how much fruit there was and used too much fruit at once. I also think the last batch of pectin was from an older box. Also, my daughter helped, so she may have cooked it too long; I'm not sure. But at least we were able to rescue about half of the runny batches and remake them properly.

The rest of the syrupy jam we just made into Plum Fruit Leather, using both the oven and a dehydrator. Same great flavor, and at least we didn't waste it!


Resources and References


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Monday, 22 October 2018

Fatshion: Autumn Look with Firmoo

Disclosure: I received products for this post. All opinions are my own. Hi friends! I’m so excited to share this Autumn look with you featuring Firmoo eyeglasses! Fall is my favorite time of...

Read more here!

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Is It Ok To Call Fat People Fat?

Actual SizeI frequently get asked something like “not everyone likes to be called fat, so when I’m talking to groups, or people whose preferences I don’t know, or if I’m writing about fat people, what terms should I use?”

It’s a good question, and there isn’t a single answer, but I’ll try to get the discussion started here:

When talking to someone one-on-one, you’ll want to use whatever they prefer – fat, curvy, plus-size, fluffy, whatever. Depending on your relationship, it may or may not be appropriate to talk about terms (ie: I’m happy to call you overweight if you prefer, I don’t personally use that term unless I’m specifically asked because it suggests that someone’s body is the wrong weight which I avoid since I personally practice body positivity…) You need to decide if it’s appropriate, and I would suggest (especially if you personally are not fat) that you err on the side of just using the term the person prefers unless you have a very close relationship with this person.

When it comes to groups or writing, there are words to avoid, and words that you can use. Let’s start with those to avoid:

Avoid words and phrases that pathologize body size either directly or by comparison, like:

Obese

The idea that our weight in pounds times 703 divided by our height in inches squared gives a health professional tons of information about our health and treatment options is pretty messed up, and that’s before you take into account the fact that the “obese” definition includes Dwayne Johnson (The Rock).  In addition to being an annoyingly useless abuse of mathematics,  it’s dangerous to those of us who fall under its numerical construct,, causing healthcare professionals to focus on height weight ratio instead of their actual patients, even making them believe that they can diagnose mental and physical health issues from a picture of someone they’ve never met.

Overweight

To me this is offensive because it suggests that someone’s body is wrong.  It’s body shaming. Over what weight?  Saying that someone is “overweight” is saying that:

  • There is a weight that they should be.
  • They are more than that weight (with the connotation that this is a bad thing.)
  • It’s somehow our job to decide how much other people should weigh.

And that’s crap. People are lots of different sizes for lots of different reasons and it’s not our job to tell them that who they are is somehow too much person.  People come in different sizes and unless they ask us for an assessment of their body against some measure, then it’s not our place to say that they are “over [some arbitrary] weight.”

Normal Weight

“Normal weight,” along with the two terms above, form the basic classes used in the (totally bullshit) Body Mass Index Chart. There is really no such thing as a “normal weight” this is just a term that was created as a base from which to pathologize other body sizes.

Healthy Weight

Again, not an actual thing. Remembering that health is not an obligation, barometer of worthiness, or entirely within our control, the truth is that people of all sizes have health issues, and there is no weight that you can reach that will make you immortal unless and until you get hit by a bus. The conflation of weight and health is at the root of so much fatphobia, including and especially fatphobia in healthcare.

What If I’m Talking or Writing About Studies That Use These Terms?

If you are discussing studies that use terms like “obese,” “overweight,” or “normal weight” then put them in quotation marks and include a content note like “These are terms used in this study, we do not agree with these terms as they pathologize body sizes and are inaccurate.”

So What’s The Deal With Using Fat?

Fat is used by many people (including me, for the reasons I outlined in detail here,) but may be triggering for others – especially in setting like eating disorder recovery.  In other situations, it can be useful to use the word fat and explain that it is just an adjective like any other. The problem is that people have heaped negative connotations on it because of fatphobia, and the fact that we search for euphemisms and talk around the idea of being fat (ie people will say “You’re not fat, you have fat,” but they would never say “You’re not thin, you have thinness” or “You’re not brunette, you have brown hair,”) is indicative of the problem. So, learning to use fat as a neutral descriptor can be a part of dismantling size-based oppression. But it’s probably best if that work is led by fat people (as opposed to thin people telling fat people what to – and what not to – call ourselves.)

Using “fat” may not always be appropriate, so you can also use many other neutral terms that people, including fat activists and clinicians who work with fat folks, use. (Remember, no community is a monolith and so there will be fat people who like and dislike each of these terms.)

Person/People of size  – For a person of size, it is more difficult to find clothing that fits their body and personal style. People of size are demanding better fashion choices.

Larger body – For those who live in larger bodies, weight-based oppression among doctors can compromise their healthcare.

Heavier body – Having a heavier body can mean being the victim of bullying.

Bigger Body – Living in a bigger body can mean being discriminated again on public transportation and commercial airlines.

Plus Size  – Being a plus-size athlete may mean that you have to deal with stereotypes and fatphobia just to run the same 5k as everybody else.

So that should get you started. Are there other words that you use or avoid? Feel free to keep this discussion going in the comments!

Did you appreciate this post? If you like 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:

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 training for an IRONMAN! You can follow my journey at www.IronFat.com or on Instagram.



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Wednesday, 17 October 2018

the HAES® files: Never too much: Reflections on accessibility and fatness

by Gabrielle Hruska

In the summer of 2017, I woke up one Wednesday morning, unable to walk. The pain was so intense in my right hip and ankle, and my left knee. Unbearable pain, with absolutely no recognizable reason. I went to Urgent Care, the doctor there thought maybe I had Lyme Disease, she advised me to take antibiotics, and to see my regular doctor BEFORE THE WEEKEND. By the next morning, I was unable to take the pain and went to the Emergency Room. In Radiology, they thought I had been in a car accident. After 4 days in the hospital, it was determined that I had Reactive Arthritis. Reactive Arthritis is really rare, and was described to me, as precipitated by a “perfect storm” in the body. Some kind of infection combined with food poisoning, and after the food poisoning passes, your body can go into Reactive Arthritis. I did not test positive for any kind of infection, nor did I have food poisoning… I have no idea why this happened. It takes anywhere from 6 months to a year to recover from Reactive Arthritis, and my Rheumatologist says I will always be susceptible to a flare up. I spent the entire summer using a walker. I fought desperately against the supposition that “Of course this happened, you are fat.”

My eyes were opened to my own biases, and to others’ biases. I was ashamed. I thought, if I were thin, people’s reactions would be so different. To fight against that awful and false narrative, I became very performative. “The Good Fatty” trope was my life. I joked about my walker, I joked at work about making a music video with the beginning sounds just being the “shhhhhhhh” of my walker gliding on carpet. My work thought that was hilarious, and they made a commercial with me and my walker. Shooting that commercial left me in bed for days. I had overdone it, in order to avoid being seen as “lazy”. I had been willing to sacrifice my own health and well-being, for what? To avoid being seen as fat and lazy. The truly awful part of this is, no one had to SAY anything. This was all internalized shame, and fear of rejection that was handed to me by a society that places so much value on thinness, that our ACTUAL HEALTH does not really matter, as long as you are thin.

Eight months after that, my mom was diagnosed with cancer in February and went immediately to home hospice. While in hospice, my mom, who had pancreatic cancer, had an appointment at her doctor. At this point, my mom was in a wheelchair, she looked small and so ill. Her pain levels were unbearable. When getting on the scale, my mom made a big deal of not saying her weight out loud. My mom was so weak, she could barely hold her head up, but she was adamant about not having her weight said out loud. When she saw her weight, my mom, did a fist pump and said “Yes! I’m down 10 pounds.”

I had to leave the room, because I was about to explode with grief and anger. My mom was celebrating losing 10 pounds, because CANCER WAS EATING HER BODY. I was not angry with my mom. My mom is a victim of society. A society that tells us that we are worthless unless we are thin. And I say, “FUCK THAT”.

As a result of losing my health, over-performing in order to hide how sick I was, because, no way could I be FAT and UNHEALTHY, and my mom struggling with her weight even in her last days, I decided, I was no longer going to subscribe to this bullshit.

I quit my job, I decided to create a completely accessible space to ALL bodies, fat, thin, differently abled, ALL BODIES. I’m in the process of opening a coffee shop and yoga studio that focuses on accommodating bodies of all kinds.
At first, I worried that I was excluding folks by really focusing on larger bodies. That maybe thin folks would not even want to be identified with a place that talks about the importance and beauty of fat bodies. And then this happened:

Rain had just started to sprinkle on the windshield as I parked my car. I was just arriving to a half-day meditation retreat at a local University. Parking was not at all near the venue. Instantly, I thought, this is not accessible at all. How do students navigate this? I felt my defenses rise, my heart beat picked up a little, and a small knot formed in my tummy. “Will it be too far for me to walk comfortably? Will I fit in the seats provided?” Defensiveness of my body size and abilities roared up in me.

Should I bring my bolster, just in case there isn’t a chair I fit in? But, it was raining and a couple blocks away. Inner dialogue: “You are being silly. No one cares about your body size, this is a meditation retreat, this should be accessible. It’s fine. Leave your bolster, otherwise it will get all wet and I really do not want to deal with a wet bolster.”

I should have brought my bolster.

Upon arriving, I see all the chairs have arms. Trying to squeeze myself into the chair, the arms cutting into my thighs, I thought, “There is NO WAY, I am going to get anything out of this, if I have to sit in this chair. I am on par for bruises on my thighs.” I waited through introductions, and when the facilitator came around to pass out name tags, I asked, “Is there alternative seating, I don’t fit in this chair.” The facilitator’s face fell, she apologized and said there were prayer benches to use. I got one, and I literally did not fit in the bench. The name “Prayer Bench” is misleading. It is not a bench at all. It is a seat base, that you then have to bend your knees into, and lean your shins on padded boards to hold you up. No back, no arms, and it rocks. Yes, it rocks. I was forced to sit with one leg between the shin pads, one leg on the outside of the shin pads, and then hold myself steady. I was so pre-occupied with balancing and trying to be comfortable-ish, that meditating was not possible.

I was SO ANGRY. Why is my body so hard to accommodate? It isn’t. Chairs with no arms, pretty simple. Unfortunately, fat bodies are RARELY considered when designing spaces. Not to mention, differently abled bodies. If I had still been using my walker, my body would not have been ok to walk the blocks to the venue.

A light bulb went off over my head. There will NEVER be TOO MUCH accommodation. There will never be TOO MUCH conversation around body and fat acceptance. There will never be TOO MANY spaces that love on all bodies. Radically loving all bodies is my mission, and I hope it can become yours as well. You do not need to quit your job and create a public space. You COULD make your own spaces accessible, you could be aware of your self talk, and love on YOU. That is the first step, loving on yourself, just exactly as you are.

 


Gabbi Hruska, Fat Activist and Owner of Real Life Coffee &Yoga in Saint Paul, MN. Gabbi lives in Saint Paul with her son, a daughter in college, two doggos and a saucy kitty named Billy. Her favorite place to be is sitting on her front stoop with a hot coffee and a good book.



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Tuesday, 16 October 2018

We Remember: Pregnancy and Infant Loss


October is Pregnancy and Infant Loss Awareness Month. I have a number of friends who have lost babies to miscarriage, stillbirth, or early death. It's more common than you might think. My heart always is heavy when I think of the babies missing in their lives, of who these babies might have become.

If you know someone who has lost a baby to miscarriage, stillbirth, or early infant death, please give them sympathy and a listening ear. Don't tell them how to feel or second-guess their situation, but just listen. If the time seems right, ask them how they are doing or offer to just hold them. They may not want to grieve in front of others, so a card or a message of love and support can be helpful yet still allow them to grieve in private. Take your cue from the mother as to what kind of support she needs. Don't assume she'll be "over it" in a month or two. That loss will likely live on in her heart forever.

We remember:
the babies born sleepingthose we carried,
but never held,
those we held,but could not take home.those who came home,
but could not stay.





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Fat Is Not A Violation

fat people have the right to existFat people on Instagram have been noticing a disturbing double standard when it comes to supposed “violations” of Instagram’s guidelines, especially in pictures that show some skin.

User @Laceangelmodel posted a picture that was removed despite her being fully covered with the comment “This photo was removed and taken down for being a violation. Where?I’m fully covered!!! Someone threatening to kill me in my comments was not a violation, but this photo is.”

Instagram Photo

Instagram Photo

It’s especially disturbing when compared to what thin people can post with no problem.

Instagram Photo

It’s not just pictures that are being removed — though that would be bad enough. Accounts are also being “shadow banned” — a practice where IG limits who can see pictures to the user and their followers, vastly reducing their ability to be found and seen, especially through hashtags.

As @fullerfigurefullerbust put it “‪I’ve defo been shadow banned on instagram – I can tell because my posts never make ‘top posts’ on hashtags with few posts, and my likes have vastly depleted. If I were a slim woman posting similar content then this wouldn’t happen. Fat bodies are being muted, and I’m not ok with that. I post content that I know for a FACT empowers and emboldens others, and yet because my body isn’t ‘perfect’, I’m given a disadvantage. The size 10 women showing how at some angles they have chins and a stomach roll get 468010k likes – because that’s acceptable. That’s temporary. My big fat body isn’t. And it’s punished.”

Instagram has already been under fire for treating female and male presenting nipplesdifferently. This new inequality in moderation is, like the ‘free the nipple’ protest, about the autonomy of women and femmes. It’s also about the ability of fat people to have and be role models. Representation matters; a fat person searching for the account of a fat person they admire, or searching a hashtag like ‘fatpositive,’ should be able to see positive representations of fat bodies without size-based censorship from Instagram.

Sarah Rosen @sehustlerosen and Lou Xavier @misslouxavier had enough. They decided to fight back with an online protest using the hashtag #fatisnotaviolation.

Read the Rest of This Piece (and see some of the amazing #fatisnotaviolation contributions) Here!

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

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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 training for an IRONMAN! You can follow my journey at www.IronFat.com or on Instagram.

 

 

 



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Tuesday, 9 October 2018

Women Are Dying From This: Taking Cesareans Seriously


When women have cesareans, they are rarely warned that a possible complication can be placental problems in future pregnancies.

Many women (and especially higher weight women) are pressured into cesareans in their first pregnancy. Many of these same women are counseled away from Vaginal Birth After Cesarean (VBAC) and into repeat cesareans in subsequent pregnancies.

Few of these women have been told that cesareans raise the risk for Placenta Accreta, a very serious complication, and that every cesarean increases the risk for it. I know *I* wasn't told this. This is a tremendous disservice to parents and to the importance of informed consent.

About Accreta

In Placenta Accreta, the fertilized egg implants near or on scar tissue in the uterus. This scar tissue is usually from a prior cesarean, but can also be from a D&C procedure, fibroid removals, a perforation from an IUD, or any uterine surgery or instrumentation. The placenta then grows into the uterine wall in this scar tissue. After the baby is born (often prematurely), the placenta can't separate properly and bleeding can become prolific. If the bleeding is not resolved, the mother can die.

There are degrees of Placenta Accreta. When the placenta grows into the uterine wall, that's Placenta Accreta. 

When the placenta invades the muscles of the uterus, that's known as Placenta Increta.

When the placenta grows through the uterine wall and into nearby organs like the bladder, that's called Placenta Percreta. All are extremely serious conditions, but percreta is the most serious of all.

The accreta rate has risen over the years as the cesarean rate has increased. Doctors are seeing more and more cases these days of what used to be a very rare complication. Some data indicate that the accreta rate has risen from about 1 in 4000 in the 1970s to about 1 in 533 now.

You can read more about this in my blog series on Placenta Accreta.
  • Part One - What Is Placenta Accreta?
  • Part Two - Life-Threatening Complication of Prior Cesarean 
  • Part Three - Risks to Mother and Baby
  • Part Four - Diagnosis, Treatment, and a Cautionary Story
The absolute numerical risk of accreta occurring in any one person is low, even with prior cesareans. Most women who have had cesareans will not experience an accreta. However, it is such a life-threatening condition that even a relatively small incidence carries a tremendous burden of complications, cost, and potential loss of life.

The more cesareans you have had, the greater the risk for accreta. In one very large study (Silver 2006), accreta was present in:
  • 0.24% of women undergoing their first cesarean (previously unscarred)
  • 0.31% of women undergoing their second cesarean (one prior cesarean)
  • 0.57% of women undergoing their third cesarean (two prior cesareans)
  • 2.13% of women undergoing their fourth cesarean (three prior cesareans)
  • 2.33% of women undergoing their fifth cesarean (four prior cesareans)
  • 6.74% of women undergoing their sixth or more cesarean (five or more prior cesareans)
This is why it is important to avoid automatic repeat cesareans and to keep VBAC a viable choice. Multiple repeat cesareans are the single most preventable factor for accretas. 

Accreta does sometimes occur after only one cesarean, like the woman in the video below, and that's why it's important to prevent a first cesarean whenever possible as well.

One Mother's Accreta Story

This mother had only had ONE prior cesarean, but still developed accreta with baby #2. Her first cesarean was a planned cesarean, urged by her OB. She was never warned that her cesarean meant accreta was a potential risk for the future.

THIS is why the high cesarean rate matters. On a case-by-case basis, a cesarean can be a good thing. But the public health implication of a high cesarean rate is that more women will develop life-threatening complications like placenta accreta, more babies will be born prematurely, and more women will die or experience permanent damage. Sometimes even after only one cesarean.

If we want to decrease maternal mortality rates and prevent complications from accreta, we MUST decrease cesarean rates. As the mother in the video below states:
A cesarean can be a life-saving intervention. The goal is not to eliminate cesareans. The goal is to make decisions regarding cesareans appropriately, and to recognize that even an uncomplicated cesarean and recovery can still put the mother at significant future risk....


She continues:
"There are too many cesareans now, 1 in 3 births, and researchers estimate that as many as 50% of those are unnecessary. 
And since a prior cesarean is a significant risk factor for developing a future accreta, that means that there are women developing accreta when it could have been prevented. So the easiest way to reduce the amount of accretas is to reduce cesarean levels... 
Women are dying from this, and mothers are dying from this. We need to take the risks of a cesarean seriously."




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We got this when we got us!

Image result for connection
Everything is so heavy right now, dear ones. Things in the world, things in our lives, the fucking patriarchy fucking everything up somehow faster now. I can’t heal that pain for you. I can’t heal it for myself, either. It hurts a lot, like constantly. I don’t have the answers to these things, but I do have some advice for us all to take heed. Hold onto the good ones in your life. Like, literally! Spend time with those you care about, even if it’s just sitting in a room looking at your phones. Seriously. Find the time to do something with the folks you can’t imagine your life without. We don’t know how long any of us have in this realm. Everything is temporary and nothing is certain, except love. Love is certain. Love is what gets us through!

Love bonds and binds us to each other and allows our connections to bring and give strength back. It’s a beautiful cycle! We must nurture these relationships and I know it’s hard. Set reminders, or even put it on your calendar, to text people or to call or email them. Tag them in a lovely photo that made you think of them on your social media. A simple, “Thinking of you!” is often the sweetest and yet most unexpected way to brighten one’s day. Tell them you miss them. Tell them you were thinking about that time in the car when that song came on and you both belted it out at the top of your lungs. These things matter so fucking much! These small and seemingly unsubstantial things can make such a difference for you and the other person. You will feel less alone and afraid in the world, I promise.

Image result for connection

(Text: Each friend represents a world in us, a world possibly not born until they arrive, and it is only by this meeting that a new world is born. Anais Nin)

We can’t let the greedy bastards keep us down and this is such a great and free way to keep your head up. I believe in our collective goodness. I’m skeptical and bitter as fuck, but the humans in my life that I am connected to have gotten me through so much worse. You will find the faith we all often feel is lacking in our lives, faith in each other, and ourselves. It’s there, it’s already inside you. You just have to set it free by reaching out to another. That’s it. That is, to me, the purpose of life. To love and to share and to connect. That’s it!
This feeling of the bad guys always winning will wane. We will see brighter days ahead. But as crisp the autumn air begins to nip our cheeks, we must also find warmth and comfort in each other. I feel that I have lost so much this year, mostly friends that have left our realm through illness. Others simply moved away out of necessity or better opportunities. It hurts and I do feel a deep heartache over it, but I keep on keepin’ on because I know those friends are still in my heart and always will be. Technology can feel like too much to bear at times but it can also be the tether that keeps us from drifting too far away from those hearts that can carry us through. We deserve this love, these connections, we all do! Do not fear in the name of feeling silly or awkward or uncomfortable…fuck that! Lean into the awkward and say it out loud and have a laugh at it together, because life is too fucking short and precious to put off that conversation for another day. It won’t be less awkward on that future day, so just get it over with! Thinking about doing something that might be difficult or slightly uncomfortable is way the hell worse than actually doing it and being done with it.
Take care of yourself first and most of all. Sit with whatever feelings you’re feeling and consider what your truest self needs to feel fulfilled. I don’t mean what will help you fit in or be cool or anything of that nature. No. I mean when you look at your life and consider your true inner self, is there anything missing? Does someone or something specific come to mind? Are there immediate obstacles or is it a matter of internal processing that is required? Only you know what matters most to you. I trust that you will seek it out and use your own fulfillment to lift others, too.
I’m going through yet another avalanche of life at the moment and the stress has been really difficult for me to power through. I’m doing all I can, but have some time off planned for my b-day week. I know I need the time away, but I’m not sure how I will manage with my current need to find new housing in the next 90 days. If you know anything about the SF bay area, you know that it is not an affordable place for anyone that isn’t wealthy to live in. I have a good job, but it doesn’t pay enough for a studio apartment, so I am hoping and praying with all my might that some miracle will come through before it’s too late. I deeply fear being forced into a terrible living situation. I am fighting really hard to not let those fears take over. My nearest and dearest have been lovely and supportive and I appreciate them so fucking much! I will get through this. We will get through this. We can be there for each other and find ourselves enjoying brighter days ahead, I just know it. If you have a spare thought or wish or prayer would you send something out into the universe for me? Me and my lil’ puggo appreciate it so very much. And if you feel that you have no one to reach out to or connect with you are very welcome to reach out to me: notblueatall@notblueatall.com I am here and I will listen without judgment or shame.
Rad Fatty Love to ALL,

<3
S

(The dress is Eshakti, current, and the pic was taken at a going away happy hour for my bff Ash-Cat.)

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I’m Not Fingernails, But I Am Fat

You Forgot Your BullshitYou’ve probably seen the meme on social media:  “You are not fat. You have fat.  You also have fingernails.  But you are not fingernails.”  I’ve seen this in plenty of versions and I think it’s problematic on a lot of levels. It’s come up in a number of conversations recently and so I’m re-posting my response.

First of all, as regular readers have probably already sussed out, I would be much more comfortable if this was written from the perspective of how someone feels about/for themselves instead of dictating to others how we should feel (ie: “I’m not fat, I have fat” instead of “You are not fat, you have fat”.)  People are allowed to look at their bodies this way because, hey, underpants rule.  That said, I think it’s an idea worth some exploring.

Let’s consider some other examples – can you imagine Facebook memes that say “You are not brunette, you have brown hair” or “You are not tall, you have above-average height.” You’re not thin, you have thinness? When I’m flying in for a speaking gig I often tell the person who is responsible for picking up that I’ll be the short, fat, brunette -in the blue dress or whatever.  People often respond by telling me not to call myself fat, nobody in my life has ever told me not to call myself brunette.  Therein lies my problem with this – it seems to me that the reason to draw a distinction between being fat and having fat is that we are considering being fat to be a negative thing from which we want to disassociate, and/or we want to see it as so temporary that we don’t want to be identified as fat.

I don’t think the research suggests that most fat people will remove our fat.  Regardless, knowing that it’s possible that time and circumstance might change the size of my body, I don’t think that’s a reason to not identify the way that it looks now. I call myself a brunette even though it’s basically a certainty that I will someday have hair that is gray and not brown. So even though there’s the possibility that my body may someday not be fat (through illness etc. – it’s certainly not a goal of mine) I’m definitely fat right now. So why would I want to find a semantic way out of it?

The problem isn’t that fat people exist. The problem is the way that fat people are stigmatized, stereotyped, bullied, marginalized, and oppressed. I’m don’t think this can be solved by “having” instead of “being” fat. To me the fact that identifying a body as fat is considered an insult is a symptom of a problem, not the actual problem – so this can’t be solved through wordplay.  If brunettes were being oppressed I don’t think there is much to be gained by saying that I’m not a brunette, I just have brown hair.

Similarly, since fat people are being oppressed, I don’t think there is much to be gained by saying that I’m not fat, I just have fat.  Mostly because no matter how I describe myself, people can still see me, and these oppressions are based on how I look to others, not on how I describe myself.  I also understand that the word “fat” has been used as derisive and I understand that not everyone is into using it as a reclaiming term and everybody gets to decide that for themselves.  For me, using the word fat to describe myself without apology tells my bullies that they can’t have my lunch money any more, and avoids pathologizing my body in the way that terms like “overweight” and “obese” do.

It’s possible that people would give me slightly better treatment (however begrudgingly) if I said that I’m not fat – I have fat, or if I characterized myself as being “overweight” in a way that indicates that I believe there’s a problem with my body.  I’m ok with passing on that “approval”, because  I am far more interested in fighting stereotyping, stigma, bullying and oppression, than I am in trying to avoid it through wordplay or concessions that I can make to my oppressors.  Other people may see this differently and/or make other choices than I do and, of course, that’s completely fine. But as for me, I am fat because I have fat and I’m fine with that.

Did you appreciate this post? If you like 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:

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 training for an IRONMAN! You can follow my journey at www.IronFat.com or on Instagram.



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Tuesday, 2 October 2018

Weight Watchers By Any Other Name Would Still Be A Fraud

Deja Moo_When you know you've experienced this bullshit beforeWeight Watchers announced on Monday that they are changing their name to WW to reflect their focus on wellness and health. This is probably a clever move, though it’s not the first time they’ve made it. In 2015, they launched a program called “Beyond the Scale” that seems to be the same thing they are talking about now, minus the name change.

This idea that “everything old is new again” has been a long-running theme for the company. They have built their business model on getting repeat business from the clients they repeatedly fail.

You see, WW has never had success is creating sustained long-term weight loss. It’s a shameful track record — one they share with literally every other diet and lifestyle company that claims they can produce sustained, long-term, intentional weight loss. They know that most people lose weight short-term and almost all of them gain it back long term (with a majority gaining back more than they lost).

Moving forward, they will go by WW and will “focus on wellness.” They made sure to mention that they are still weight-loss focused, saying “We will never abdicate our leadership in the best healthy eating program for weight loss in the world, but we can be so much more today…” This isn’t their first foray into attempting to co-opt the language of Size Acceptance and Health at Every Size to sell diets — even as they’ve put out blatantly body shaming ads.

It’s easy to see the profit rationale for their hypocrisy. They get to continue selling their program to people, who they spent years successfully convincing to hate their bodies, and try to open up a new market amongst the people who have crawled and scratched their way up and out of the diet culture that Weight Watchers, excuse me, WW, immersed them in. So, it will likely make money, but that doesn’t make it right.

People are allowed to do whatever they want with their bodies  —regardless of the reasons, risks, or likelihood of success. And while I’m grateful that they seem to have stopped targeting children, that does not change the fact that it is impossible to sell weight loss from a wellness perspective. Here’s why…

You can read the rest of the piece here!

Did you appreciate this post? If you like 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:

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 training for an IRONMAN! You can follow my journey at www.IronFat.com or on Instagram.

 

 



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