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Friday, 12 May 2017

Fear

There is a pillar of stone in the middle of a deep, gurgling swamp. On top of the pillar is a small fire, some food, a basket for collecting rain water, and a tent. The food never quite runs out, the fire never fully extinguishes. Rain always comes, eventually. Atop the pillar she watches the seasons pass, charts the stars in their courses, observes the alligators and piranhas down in the muck live their lives, and some nights when the moon is dark she sees a glimmer of something in the far distance. There is something beyond the swamp's borders, something more than a pillar of stone, food, water and shelter. She has tried to reach it many times. 

It always happens the same way; she will feel brave, prepared both mentally and physically. She has a Plan to avoid the alligators and piranhas. This time will be different. This time she will succeed, moving forward bearing the marks of previous journeys; bite marks, scratch scars, and those inside where she wakes at night. In the past she had been rescued by others passing by, people with nice boats who returned her to the pillar, healed her wounds, then left on their own journey. Rescue comes when she can no longer fight off the creatures of the swamp, when she is bleeding from a hundred wounds and is ready to lay down and drown, when the stench of it, the deep sucking mud has pulled the strength right out of her bones. 

The stars pass overhead many times, shifting slowly in their eternal dance with the sun and moon. The food never quite runs out. The rain always comes eventually. The shimmer on the horizon continues to beckon in the night but she sits with her back to it and instead gazes into the fire. Here she is warm and safe.



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Thursday, 11 May 2017

Fatshion: Black Floral Midi Dress

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Study Shows Link Between Discrimination and Type 2 Diabetes

Public HealthFat causes [insert health issue here.] We here this every day.  The problem is, it’s not true. The research about weight and health isn’t about causation, it’s about correlation and that’s an important distinction.  Correlation means that two things happen at the same time.  Causation means that one thing is the result of the occurrence of the other thing.

This is not an unimportant distinction.  Let’s say that men with certain types of baldness have higher rates of heart attacks.  Let’s say the correlation is extremely high. So, healthcare practitioners say that obviously we’ve got to help these guys grow hair so that they can reduce their heart attack risk!  But let’s say that the treatments that lead to men growing hair only work on about 5% of men, the rest grow hair in the short term but lose it all again in a couple of years with a majority ending up with less hair than they started with.

So let’s say that healthcare practitioners (encouraged by people who sell the hair regrowth treatments) blame the men, claiming that anyone who tries hard enough can grow hair. People start to calculate the cost of these guys heart attacks and calling them a “drain on society.”  The government starts a War on Baldness and every person that bald men come in contact with are encouraged to let them know that they need to grow hair, that they are obviously weak willed, and they are a drain on society.  It becomes ok to not hire bald men (so that the companies insurance isn’t affected.) People suggest that maybe bald men shouldn’t qualify for insurance, or healthcare at all until they do what it takes to grow hair.  A dangerous surgery is developed that may help men grow hair, but is also likely to leave them with lifelong side effects, and the surgery kills many of them.

If this sounds ludicrous then look no farther than the way that fat people are treated. It’s happening right now. The thing about bald men having higher numbers of cardiac incidents is true by the way – and the correlation is very high. But what researchers found when the dug a little deeper was that both the baldness and the cardiac incidents were caused by a third factor.  That’s not unusual, the thing about correlation is that if A and B are correlated it’s possible that A causes B, it’s possible that B causes A, it’s possible that A and B are both caused by a third factor, and it’s also possible that they are, in fact, unrelated and the correlation is a coincidence.

I’m bringing this up because a new study shows a correlation between discrimination and Type 2 Diabetes. This isn’t new, Peter Muennig found correlation between stigma the comes with being fat in a fatphobic society, and the health conditions that are correlated with being fat.

This doesn’t just apply to fat people, it’s an issue for every marginalized person. And it’s one more way that hate speech and discrimination affect us negatively.  The study found that those who reported two or more major discrimination experiences had a 34% increased risk of diabetes (over nine years) than those with no reported experience of major discrimination. In terms of health care for fat people this is important because, while we don’t know how to make fat people thin, we do know how to stop discriminating against them and we can start right now (and of course that goes for other marginalized groups as well.)

The lead author, Kara Whitaker, said ““It may be beneficial for clinicians to ask patients about their experiences with discrimination as an additional method to identify individuals who may be at increased risk for developing type 2 diabetes or cardiovascular disease.”

I agree, but as a fat person who has dealt with all kinds of fatphobic nonsense at the doctor I would suggest that it may be beneficial for clinicians to ask themselves if they are contributing to that discrimination.  And people who create public health messaging should make sure that their messages aren’t adding to discrimination.  And while we’re at it, it’s important for all of us to remember that “everybody knows” is not the same as “evidence shows,” and correlation never ever, never ever, implies causation.

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Wednesday, 10 May 2017

If you’re trying to make a problem worse, I have trouble believing you when you say you’re solving it.

The New York Times recently published an op-ed arguing that all economic problems with abortion can be solved with private charity. It should be obvious to anyone paying attention how false that is.  It’s nice that, in the course of lying to you about breast cancer and depression and withholding your test results, a crisis pregnancy center might also hook you up with a low-cost car or help you with utility bills. But that only scratches the surface of the economic issues–everything from life-long medical costs from pregnancy complications to lower earning potential as someone with a kid to take care of. Crisis pregnancy centers frequently stop helping women as soon as they can’t obtain a legal abortion.  They’re certainly not going to help with daycare costs when the kid you didn’t abort is five, or help you out with the cost of insulin for the next twenty years if gestational diabetes never goes away.

It occurred to me that crisis pregnancy centers are, as far as I’m aware, the only charities working on an issue who are actively trying to make sure more people need their services. Every other organization at the front lines of addressing a problem at least encourages measures that would prevent the problems they address in the first place. Animal rescue groups hold free spay and neuter clinics and encourage people to get their pets fixed. Groups who help homeless people find places to stay are also often trying to address substance abuse, mental illness, and economic issues.  And you won’t see crisis hotlines for LGBT kids saying, “Sure, go ahead & reject your kids for being gay! We’ve got this covered.”

Crisis pregnancy centers, in contrast, actively oppose measures that would result in fewer unplanned pregnancies. The author of the NYT Op-Ed wrote an abstinence-only “sex ed” curriculum—the very kind that drives up teen pregnancy rates. Additionally, by trying to make abortion illegal, they’re looking to massively increase the number of people who need their assistance.

There were about 660,000 abortions reported to the CDC in 2013, and there are between 2300 and 3500 crisis pregnancy centers. Divided evenly, that’s a couple *hundred* additional people in need of help per clinic per year, without even counting the increased abortions if schools that are currently teaching medically accurate sex ed switch to abstinence only.

An American Independent article lists some statistics on the number of people seen by crisis pregnancy centers. According to the Family Research Council, approximately 230,000 ultrasounds were performed at a thousand centers, 230 per clinic.  Even if those centers only did ultrasounds for *half* of the pregnant people they see, providing services for the 650,000 people who currently have abortions would be a 50% increase.

Any other charity might panic at the idea of 50% more people needing their help.  Ask a homeless shelter to add 50% more beds or a cancer treatment center to see 50% more patients, and they’ll be frantically trying to figure out where the money, staff, and resources will come from. But a CPC’s apparent response is a shrug and a blithe “We got this.”  The op ed doesn’t mention any such numbers, or any concrete plans for how the author’s organization would handle such an increase, only the vague generalization that conservatives “must sacrifice their time and treasure to serve women in need”. It’s worth mentioning that this sacrifice of time and treasure is totally voluntary, with no guarantee it’ll actually happen if abortion rights disappear.

To me, that’s a pretty strong indication that CPCs aren’t looking to solve the economic problems associated with unplanned pregnancies as much as they’re trying to put a fig leaf over them. “See, women don’t need abortions! Crisis pregnancy centers will provide them with charity so they can take care of their babies.” Whether their help is sufficient for the actual needs of the pregnant person isn’t really their concern, as long as they prevent that person from having an abortion.

(Hat tip to @AnaMardoll for her thread on how disingenuous the idea that abortion isn’t an economic issue “because private charity” is)




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Tuesday, 9 May 2017

the HAES® files: Food is the New Classism

by Glenys Oyston

The argument (really just a friendly debate; not an actual fight) has stuck in my head for years.

A self-proclaimed foodie friend and I were discussing the qualities of the best grilled cheese sandwiches. I declared that my favorite was still the kind made with processed cheese slices. She was horrified. “Ugh no!” she gasped. “That’s not REAL cheese!”

I burned a little with shame remembering my childhood growing up eating my mother’s classic grilled cheese sandwiches made with those processed cheese slices that came wrapped in plastic, the bread slathered on all sides with butter – one of the few foods I really enjoyed through those years. It never occurred to me back then whether my food was “real” or not – it was just the food I ate.

As a dietitian, I now know that processed cheese does in fact contain “real” cheese which has been combined with emulsifier and some other ingredients to make it melt better and last longer. This was a fun fact we learned in food science, where food additives were demystified. All food is “real” food – we don’t create it out of thin air from non-edible sources. We don’t turn, like, plastic chairs into donuts. Some food may be more “processed,” but it is still food.

Sadly, we live in a culture where all types of foods are demonized for various reasons. For a while, some time ago, I indulged in this behavior myself (I’m not proud). Once into adulthood and well out of the lower socioeconomic class I was raised in, I wanted only the “freshest,” most “organic,” “grass-fed,” “local” foods I could get my hands on. (This was, unfortunately, one of the ways in which I propped up my extreme disordered eating.) I was ashamed of some of foods I grew up on: frozen pizzas and TV dinners, packaged sweets, canned vegetables. The diet that, while perhaps not optimal, kept me alive.

Ironically, many of us have dieted on “processed” foods, encouraged by all to do so in the name of thinness; or we might even eat or drink them as a part of a regular diet. During my smug-foodie days, I wouldn’t have thought twice about eating a highly processed, low-fat, packaged dessert-food to save calories, while snubbing my nose at conventionally farmed chard as not being “healthy” enough.

In reality, there are many foods that are processed that no one complains about. Coffee, especially decaf, is highly processed and it never goes out of style. Bread is somehow supposed to better for us in Paris than here, despite the fact that it is still white bread (gasp!). That soy milk didn’t leap out of the bean on its own; it was processed out. Vegan foods made to look and taste like meat are also highly processed, yet remain virtuous. And the greatest mystery to me – people following so-called “whole foods” diets who have no problem blending up protein powder (processed!) with everything.

Despite the complete hypocrisy of it all, there is still so much judgment being tossed around about food and health. This isn’t really a new phenomenon; I remember after diving into diet culture more than 20 years ago hearing people poo-poo the diets of the “lower classes,” attributed to an ignorance that could be cured only by benevolent education (read: shame) from better-off people. Ew to all of that.

Yes, it is well documented that higher weights (I’m refusing to use the “o” word here) are prevalent among people with less education and less money. So often –really often! – I’ve heard this chalked up to a “processed food diet” issued in a “shame on them” tone. Rarely is food insecurity, food availability, stigma or stress discussed, all possible contributors to higher weights, all problems experienced in lower socioeconomic classes. “Just eat better food!” is the standard advice. Case closed, problem solved, further thought not needed.

Let’s call this what it is: classism. When some foods are okay being processed but others aren’t, it’s not about the food; it’s about who’s eating it and proclaiming one’s righteous status through the stigmatization of others’ diets.

If we want to actually help people to live better, let’s talk about making more food more available and affordable. Let’s smash a diet culture that creates food-fear in the name of profit. Let’s talk about food justice issues without stigmatizing people for what they eat or weigh, because this does not contribute to health. As a Health at Every Size® dietitian, I truly do feel that all foods can fit, but they only fit well if someone can afford them and feel good about eating them.

I still sometimes eat grilled cheese sandwiches with processed cheese slices. Sometimes I use the other kind of cheese (which is still “processed,” by the way, as most foods are to some degree). I eat “whole” foods and the supposedly “unholy” foods, too. I eat all the foods because, thankfully, I can afford it now and I’m free of food-fear. Let’s focus on creating that situation for everyone instead of food and weight shaming others as a part of yet another unfair class system.

 


Glenys Oyston is a registered dietitian and eating coach who helps people recover from toxic diet culture and eating anxiety. As someone who struggled with her weight and feeling out-of-control around food for years, she knows exactly what others are going through and how to get them to food freedom. She coaches people in person in her Los Angeles office and virtually through one-on-one and group coaching programs. This year she launched Dare to Eat, an online program that helps people to learn to eat as much as they want, without guilt, in total freedom. You can find her at http://ift.tt/2q0LtsJ and on her podcast Dietitians Unplugged.


Tagged: diet, health, Health At Every Size, nutrition

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Fatshion: Little Black Dress

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Sunday, 7 May 2017

AHCA BS

I was out at Steampunk World’s Fair all weekend, so this isn’t much of a post.  But I do want to say that if you live in one of the districts of any of the 217 Congresscritters who voted for the AHCA, please yell at them.  Send them letters, fill their voicemail, @ them on Twitter.  Don’t yell at their staffers, because they didn’t vote for the bill, but please, do your damnedest to make sure that not a single one of these people is ever elected for so much as dog-catcher again.

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