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Wednesday 27 February 2019

Moving Beyond Weight-Neutral to Body Affirming

NEDAwarenessI was recently named an official Ambassador for NEDA (the National Eating Disorders Association) It puts me in absolutely incredible company and I’m truly honored. It’s NEDA’s National Eating Disorders Awareness Week, and this year the theme is “Come As You Are.”

As part of that, I contributed a piece to NEDA’s blog about making the move from being Weight-Neutral to being fiercely body affirming – a move that is mandatory if we truly want to prevent eating disorders and allow for full recovery:

Diet culture and fatphobia perpetuate eating disorders and can make full recovery impossible. They create an environment in which we, as the brilliant Deb Burgard has said, prescribe and encourage the same behaviors for fat people that we diagnose and treat as eating disordered in thin people (which also results in missing or even encouraging eating disorders in people of higher weight). The popularity of dangerous weight-loss medications and surgeries make it seem perfectly acceptable to risk a fat person’s life and quality of life in pursuit of thinness–which is not only dangerous for fat people, but also a dangerous message to send to those of any size who may have or may develop an eating disorder.

It’s difficult to believe your recovery is the most important thing when diet culture and a fatphobic world are telling you that the most important thing, by far, is being thin by any means necessary. And it’s difficult–if not impossible—to let go of your fear of being fat/gaining weight/having an “imperfect” body if you can plainly see you live in a culture where your fear is absolutely justified.

That is why we know that the Size Acceptance and Health at Every Size paradigms are the only option that makes sense if we truly wish to prevent eating disorders and allow for full recovery.

This often takes the form of creating “weight-neutral” spaces, which includes no diet or weight loss talk, no negative body talk, no fashion magazines, no recommendations of weight loss as a cure for physical health issues or for stigma, etc. These are all important things that are critical in creating spaces that don’t perpetuate oppression or eating disorders. A weight-neutral space is a good start, but if we truly want to prevent eating disorders and create an environment that allows for full recovery, we need to move from weight-neutral to fiercely fat affirming.

Read the full piece here! 

To check out all of the ways to participate in Eating Disorders Awareness Week, check out this post.

Was this post helpful? If you appreciate the work that I do, you can support my ability to do more of it with a one-time tip or by becoming a member. (Members get special deals on fat-positive stuff, a monthly e-mail keeping them up to date on the work their membership supports, and the ability to ask me questions that I answer in a members-only monthly Q&A Video!)

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!  (Members get an even better deal, make sure to make your purchases from the Members Page!)

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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Sunday 24 February 2019

Study Plans To Starve Kids “For Their Health”

No On Fast TrackIn another example of so-called medical professionals deciding that it’s acceptable to risk fat people’s lives and quality of life to try to make us thin, the Fast Track study will quite literally starve 186 adolescents, ages 13-17.

Louise Adams, Clinical Psychologist and author of Untrapped,  has written about this extensively, the basics are:

“The “Fast Track To Health” study is about to kick off in Sydney & Melbourne. The research team have a $1.2 million grant from the NH&MRC, and these funds are being used to put teenagers through a gruelling and prolonged semi starvation experiment.

Teens aged 13-17 are facing a horrifying experience: for an entire month they will be allowed just 800 calories a day. After that, for an entire YEAR of their lives, the kids will be starved for 3 days of the week, allowed only 600-700 calories a day”

Ruth Leach wrote a brilliant, extensively cited, point by point explanation of the short and long term dangers of this horror of a study, which was co-signed by 37 different professionals and sent to the Human Research Ethics Committee at Syndey Children’s Hospital Network. You can read it here.

It should go without saying that starving kids is dangerous and unethical, but  unfortunately it needs to be said:

Please consider adding your voice by signing this petition created by Louise Adams.

Was this post helpful? If you appreciate the work that I do, you can support my ability to do more of it with a one-time tip or by becoming a member. (Members get special deals on fat-positive stuff, a monthly e-mail keeping them up to date on the work their membership supports, and the ability to ask me questions that I answer in a members-only monthly Q&A Video!)

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!  (Members get an even better deal, make sure to make your purchases from the Members Page!)

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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Tuesday 19 February 2019

Thicc Not Sick video




Just had to share this. Excellent work, Kristen Bartlett and Ashley Nicole Black! You hit all the top points we've been making for years, with humor and no holds barred. Great job! And thank you Samantha Bee for bringing their work forward to a national platform.

*WarningSalty language and off-color humor, if you prefer to avoid that sort of thing


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Friday 8 February 2019

Risking Fat People’s Lives “For Their Health”

One of the ways in which diet culture harms, and can even kill, fat people is its perpetuation of the idea that a fat life is more risk-able than a thin life. The underlying belief of diet culture is that it’s better to be miserable, or even dead than to be fat.

We see this in lots of ways.

Medications being prescribed to fat people that risk our health and lives for a few pounds lost (and quickly regained.) 

Gruesome and barbaric recommendations, like pumping food out of our stomachs into a bucket, are seen as totally reasonable, without any regard for how they will affect our physical or mental health.

And of course there is the horror of stomach amputation and binding (aka “bariatric” or “weight loss” surgeries.):

A pretty clear example: a thin person and a fat person go to the same doctor. Both have elevated blood sugar. Their numbers are exactly the same. The thin person is prescribed medication with few side effects that is shown to help control blood sugar. The fat person is referred for a surgery during which most of their stomach will be amputated causing a risk of death on the table, short- and long-term death from complications, and horrible lifelong side effects. The fat person is asked to risk their life and quality of life to control blood sugar. The thin person is asked to take medication.

The same thing happens when a fat person who actually needs knee surgery is told that they can’t get it because knee surgery is too dangerous, and then they are given the recommendation to have stomach amputation surgery, which is far more dangerous with far worse possible side-effects.

Sadly this isn’t limited to adults, in Australia the “Fast Track to Health” study will literally starve children, despite the fact that the evidence does not suggest that it will do anything to change their weight, there are serious questions about severe food restriction during children’s growth years, and the study perpetrators know that they are risking inducing eating disorders. (There is a fantastic take-down of this here.)

I’m writing about this because I think it’s important to realize that when we are advocating for our health and healthcare, we are often advocating against a system that thinks that it’s worth killing us, or ruining our lives, to make us thin – no matter what we think.

Fat people have the right to exist, in fat bodies, and it doesn’t matter why we’re fat, what the “consequences” of being fat might be, or if we could (or want to) become thin. Fat people have the right to healthcare that supports our actual bodies, rather than insisting that we risk our lives to be thin before we are treated as human beings, worthy of appropriate, evidence-based healthcare

Nobody knows what fat people’s health outcomes would look like if we lived in a society that celebrated the diversity of body sizes, gave us the opportunity to love our bodies and see them as worthy of care, and the access to take good care of them. I’d like to find out

Was this post helpful? If you appreciate the work that I do, you can support my ability to do more of it with a one-time tip or by becoming a member. (Members get special deals on fat-positive stuff, a monthly e-mail keeping them up to date on the work their membership supports, and the ability to ask me questions that I answer in a members-only monthly Q&A Video!)

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!  (Members get an even better deal, make sure to make your purchases from the Members Page!)

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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Wednesday 6 February 2019

Salad-Eating Fatphobe on Plane Gets Just Desserts

Pink Background, a black and white image of thin woman in a dress and heels leans on a table and waving. Black text says "Wait, Come back. You forgot your bullshit." someecards user cardOk, let me start by apologizing for that title, I just couldn’t help myself. Now on to the good news.

A fatphobe found herself seated in the middle seat on a plane between two plus-size people, and decided that her best choice was to verbally abuse her row-mates. She started on the phone to someone, complaining loudly that they were “squishing her” (though a video taken by Norma Rodgers, one of her row-mates does not substantiate that claim) Fatphobe then turned her ire to the flight attendant saying ““Get me out of here. I can’t do this. I can’t breathe, I’m so squished,” she said, before adding, “I eat salads, okay?”

Throughout the interaction we see the cruelty of fatphobia, but here we see the ridiculousness. Seriously, Fatphobe? “I eat salad.”? That’s what you went with?  Plenty of fat people eat salad, plenty of thin people don’t. Airlines have tons of promotions but “Eat a salad, choose your seatmates” is not one of them.

What isn’t funny at all is that she is white and her two row-mates are Black, so we have to ask ourselves to what extent racism was also at the root of, and driving her behavior.

At that point, in a bit of video that makes me want to stand up and cheer in my living room, Norma Rodgers – the hero we need – had e-fucking-nough and asked the flight attendant to find Fatphobe another seat because “I will not be abused by this bitch, or anybody else, I will not be verbally abused by anybody. I’m not tolerating it.” Tell her Ms. Rodgers.

The flight attendant asks Fatphobe to move to the back of the plane while they look for another seat and as she is leaving the row she says again “I eat salad.” That’s where it gets good.

While Ms. Rodgers asks the flight attendant how to report Fatphobe, repeating that she is not going to be treated this way, and the flight attendant empathizes and assists, the rest of the plane lets Fatphobe know that her behavior is not ok. In a glorious finish to this story, Fatphobe got kicked off the plane. I can only hope that her seat remained empty so that her abused row-mates could stretch out and enjoy their Fatphobe-free flight.

A few final points:

Much has been made in online discussions that I’ve seen about the fact that Fatphobe isn’t particularly thin. I don’t care about that, since there’s no weight at which her behavior would have been appropriate.

If you’re thinking something like “Making fat people buy two seats for one flight isn’t fat shaming, it’s just economics” then head over to this post.

If you’re thinking something like “But fat people on planes taking up space aren’t fair to thin people!” then head over to this post.

If you know what’s up, then just take this time to enjoy the fact that two fat people flew to their destinations while Fatphobe watched them take off from the airport, where flight attendants booted her ass after being shamed by fellow passengers of all sizes. Progress, far too slow and far too painful, but progress.

Did you like this post? If you appreciate the work that I do, you can support my ability to do more of it with a one-time tip or by becoming a member. (Members get special deals on fat-positive stuff, a monthly e-mail keeping them up to date on the work their membership supports, and the ability to ask me questions that I answer in a members-only monthly Q&A Video!)

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!  (Members get an even better deal, make sure to make your purchases from the Members Page!)

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 4 February 2019

VBAC and Prior Cervical Dilation


Some providers look for any excuse to discourage people from Vaginal Birth After Cesarean (VBAC). They might tell you that you're not a good candidate for VBAC because you are too old, too fat, too short, that you have to have your baby before your due date, that you've gained too much weight, and on and on.

One of the tools that is sometimes used to discourage VBAC is the prior dilation in the previous labor. Some have been told that if they dilated nearly all the way or even all the way to 10 cm, they have little or no chance at a VBAC. Others have been told the opposite, that if they didn't dilate very far previously, their chances of VBAC are low.

But what does the research actually say? 

Prior Dilation and VBAC

A New York study (Hoskins and Gomez 1997) was one of the first studies to look at prior dilation and its association with later VBAC. It found a much greater VBAC rate in those who had a c-section at lower dilation. The VBAC rate at later dilation was only 13%.

However, this is the only study I could find that had more VBACs in the group with less dilation. But because this 1997 study was the first one to really examine the question, its findings have stuck in many doctors' memories, despite contradictory studies, so you sometimes still hear this argument.

A small Nigerian study (Onifade and Omigbodun, 2003) found that prior dilation had no influence on later VBAC. They concluded, "the maximum cervical dilatation reached before primary caesarean section need not be factored into a decision for VBAC."

On the other hand, most studies have found that the greater your dilation in a previous labor, the better your chances at a subsequent VBAC.

One 2001 Canadian study found a higher VBAC rate (75%) among those whose cesareans occurred after dystocia in the second stage of labor/after full dilation. Do note, though, that the group where dystocia occurred in the first stage still had a 66% VBAC rate.

A Korean study (Kwon 2009) also found that those with greater prior dilation had more VBACs.

A Danish study (Abildgaard 2013) had a very low overall VBAC rate but even so found more VBACs in those with greater prior dilation. N=373 women had a Trial of Labor. Those with 4-8 cm dilation before their first cesarean had a 39% VBAC rate, whereas those who were fully or nearly fully dilated at cesarean had a 59% VBAC rate. 

And now, a new study (Lindblad Wollman 2018) also suggests that the chance of VBAC is increased with greater prior dilation. This was a large population-based cohort study in Sweden for 6 years from 2008-2014; such a large study gives its findings extra heft.  N=3,116 women with 1 prior cesarean had a Trial of Labor (TOL). 70% had a VBAC. In those who had a prior cesarean for dystocia:
... increasing cervical dilation in first labor decreased the risk of repeat cesarean in second labor. The adjusted RR of repeat cesarean was 2.48 with dilation ≤5 cm, 1.98 with dilation 6-10 cm, and 1.46 if fully dilated. 
CONCLUSIONS: Almost 70% of all women eligible for trial of labor after cesarean had a vaginal birth, even women with a history of labor dystocia had a good chance of success. A greater cervical dilation in the first delivery ending with a cesarean was not in vain, since the chance of vaginal birth in the subsequent delivery increased with greater dilation.
Overall, the research suggests pretty strongly that the more dilation you had previously, the better your likelihood for a VBAC later. Why might that be? Perhaps the key is how ripe the mother's cervix was before labor (a ripe cervix dilates more easily), and that once you've fully dilated once, you're likely to again.

What it doesn't mean is that someone who didn't dilate very far the first time is a bad candidate for a VBAC. As the Swedish study above points out, "even women with a history of labor dystocia had a good chance of success."

But really, in the end, who cares how many centimeters you dilated last time? The point is that with patience and a supportive provider, most people will have a VBAC, regardless of risk factors. That's all you really need to know.

Providers, Stop Looking for Excuses 



As the top graphic of this post points out, VBAC is woefully underused. About 90% of those with prior cesareans are eligible for a VBAC, yet only about 10% end up having one. Yes, some people choose repeat cesareans, and some people labor for a VBAC but end up with another cesarean. However, the biggest reason for the low number of VBACs is because VBAC has been strongly discouraged by many providers.

Some providers won't support VBAC at all. Others pretend to be supportive but place so many limitations on a trial of labor that almost no one gets a VBAC. Others limit trials of labor to only those with the MOST favorable risk factors.

Providers, stop making excuses. Don't use prior cervical dilation or past arrest disorder or gestational age or Body Mass Index or maternal age or any of a thousand other lame excuses to discourage people from a VBAC.

Arbitrarily limiting VBAC to those with only the most favorable factors makes the repeat cesarean rate far too high, results in far too many complications, and does more harm than good. Our skyrocketing rate of placental abnormalities, cesarean scar pregnancies, and maternal mortality rates reflect that.

Sure, certain factors may make a VBAC slightly more or less likely, but the stark truth is that the majority of those who labor will have a VBAC, even when there are less favorable risk factors.

Stop looking for excuses to not support VBAC. Stop the high-handed paternalism that peremptorily decides birthing choices for others. Stop infantalizing women and taking away their autonomy to make their own medical decisions. People should be counseled about the benefits and risks of each option, but in the end the final choice belongs to the mother.

Unless someone has a legitimate medical contraindication, stop discouraging people from pursuing a VBAC if they want one.


References

Acta Obstet Gynecol Scand. 2018 Dec;97(12):1524-1529. doi: 10.1111/aogs.13447. Epub 2018 Sep 25. Risk of repeat cesarean delivery in women undergoing trial of labor: A population-based cohort study. Lindblad Wollmann C, Ahlberg M, Saltvedt S, Johansson K, Elvander C, Stephansson O. PMID: 30132803
... We investigated the association between indication of first cesarean and cervical dilation during labor preceding the first cesarean and risk of repeat cesarean in women undergoing trial of labor. MATERIAL AND METHODS: A population-based cohort study using electronic medical records of all women delivering in the Stockholm-Gotland region, Sweden, between 2008 and 2014. The population consisted of 3116 women with a first cesarean undergoing a trial of labor with a singleton infant in cephalic presentation at ≥37 weeks of gestation... In women with a cesarean due to dystocia, increasing cervical dilation in first labor decreased the risk of repeat cesarean in second labor. The adjusted RR of repeat cesarean was 2.48 with dilation ≤5 cm, 1.98 with dilation 6-10 cm, and 1.46 if fully dilated. CONCLUSIONS: Almost 70% of all women eligible for trial of labor after cesarean had a vaginal birth, even women with a history of labor dystocia had a good chance of success. A greater cervical dilation in the first delivery ending with a cesarean was not in vain, since the chance of vaginal birth in the subsequent delivery increased with greater dilation.
Acta Obstet Gynecol Scand. 2013 Feb;92(2):193-7. doi: 10.1111/aogs.12023. Epub 2012 Nov 5. Cervical dilation at the time of cesarean section for dystocia -- effect on subsequent trial of labor. Abildgaard H, Ingerslev MD, Nickelsen C, Secher NJ. PMID: 23025257
... DESIGN: Retrospective study. SETTING: University hospital in Copenhagen capital area. POPULATION: All women with a prior cesarean section due to dystocia who had undergone a subsequent pregnancy with a singleton delivery during 2006-2010. METHODS: Medical records were reviewed for prior vaginal birth, cervical dilation reached before cesarean section and induction of labor, gestational age, use of oxytocin, epidural anesthesia and mode of birth was collected. RESULTS: A total of 889 women were included; 373 had had a trial of labor. The success rate for vaginal birth among women with prior cesarean section for dystocia at 4-8 cm dilation was 39%, but 59% for women in whom prior cesarean section had been done at a fully or almost fully dilated cervix (9-10 cm) (p < 0.001). Among the women with a previous vaginal delivery prior to their cesarean section, the success rate for vaginal birth was 76.2%, in contrast to 48.9% in the group without a previous vaginal delivery (p < 0.01). CONCLUSION: Women who had a trial of labor after a prior cesarean section for dystocia done late in labor and women with a vaginal delivery prior to their cesarean section had a greater chance of a successful vaginal birth during a subsequent delivery.
J Matern Fetal Neonatal Med. 2009 Nov;22(11):1057-62. doi: 10.3109/14767050902874089. Cervical dilatation at the time of cesarean section may affect the success of a subsequent vaginal delivery. Kwon JY, Jo YS, Lee GS, Kim SJ, Shin JC, Lee Y. PMID: 19900044
... The medical records of women attempting VBAC between January 2000 and February 2008 were reviewed. All women had only one previous cesarean and underwent spontaneous labor. RESULTS: Among 1148 enrolled women, 956 (83.3%) achieved a successful VBAC. Birth weight, previous indication for cesarean delivery and oxytocin augmentation were significantly associated with VBAC outcome. By multivariate analysis, a cervical dilatation >or=8 cm at previous cesarean was independently predictive of successful VBAC in women with a previous cesarean for non-recurrent indications (p = 0.046), yielding a VBAC success rate of 93.1%, whereas the extent of cervical dilatation at the previous cesarean did not affect the outcome of subsequent delivery in women with a previous cesarean for recurrent indications. CONCLUSIONS: Women with cesarean for non-recurrent indications who achieved a cervical dilatation >or=8 cm may be the best candidates for VBAC, with the greatest likelihood of a successful VBAC. Labor progress at previous cesarean can serve as a valuable indicator for VBAC outcome in women with a previous cesarean for non-recurrent indications, and therefore should be discussed as part of preconception counseling.
Obstet Gynecol. 1997 Apr;89(4):591-3. Correlation between maximum cervical dilatation at cesarean  delivery and subsequent vaginal birth after cesarean delivery. Hoskins IA, Gomez JL. PMID: 9083318
... Relevant records of the index pregnancy (group I) were reviewed for cervical dilatation at cesarean delivery, oxytocin use, indication, neonatal weight, and epidural use. The records of the subsequent pregnancy (group II) were reviewed for successful VBAC rates, neonatal weight, oxytocin, and epidural use. RESULTS: There were 1917 patients in the study. The indications for cesarean in group I were ... arrest disorders (80%)... In those with previous cesarean deliveries for arrest disorders with cervical dilatation at 5 cm or less, the VBAC success rate was 67%. It was 73% for 6-9 cm dilatation and 13% for the fully dilated group (P < .05). CONCLUSIONS: Patients who attempt a VBAC may be counseled that a cesarean delivery at full dilatation is associated with a reduced chance of a subsequent successful VBAC.
AJP Rep. 2017 Jan;7(1):e31-e38. doi: 10.1055/s-0037-1599129. Validation of a Prediction Model for Vaginal Birth after Cesarean Delivery Reveals Unexpected Success in a Diverse American Population. Maykin MM, Mularz AJ, Lee LK, Valderramos SG. PMID: 28255520 Full free text here.
OBJECTIVE: To investigate the validity of a prediction model for success of vaginal birth after cesarean delivery (VBAC) in an ethnically diverse population. METHODS: We performed a retrospective cohort study of women admitted at a single academic institution for a trial of labor after cesarean from May 2007 to January 2015. Individual predicted success rates were calculated using the Maternal-Fetal Medicine Units Network prediction model. Participants were stratified into three probability-of-success groups: low (<35%), moderate (35-65%), and high (>65%). The actual versus predicted success rates were compared. RESULTS: In total, 568 women met inclusion criteria. Successful VBAC occurred in 402 (71%), compared with a predicted success rate of 66% (p = 0.016). Actual VBAC success rates were higher than predicted by the model in the low (57 vs. 29%; p < 0.001) and moderate (61 vs. 52%; p = 0.003) groups. In the high probability group, the observed and predicted VBAC rates were the same (79%). CONCLUSION: When the predicted success rate was above 65%, the model was highly accurate. In contrast, for women with predicted success rates <35%, actual VBAC rates were nearly twofold higher in our population, suggesting that they should not be discouraged by a low prediction score.
Other So-Called "Risk Factors" for Failed VBAC


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Sunday 3 February 2019

The Super Bowl, Fat People, Prioritizing Health, and Hypocrisy

Super BowlOne of the reasons most commonly given for refusing to treat fat people with basic human respect, or to represent fat people in the media as happy, or successful at anything other than weight loss, is that fat people aren’t “prioritizing our health” and thus deserve to be treated poorly and denied positive media representation.

For today I’m setting aside the fact that this is both completely untrue and that it even if it was true it would still be extremely messed up, to discuss the almost unbelievable hypocrisy that is committed anytime this argument is made and, specifically, on Super Bowl Sunday, in this annual DWF post.

Today Super Bowl LIII will be played (for those not into sportsball, it’s the annual championship game of United States Football.) It has an anticipated audience of over 100 million people. Advertisers paid $5.25 Millon for a 3o second spot.

The dudes who will play in the game – many of them meeting the (totally bullshit) definition of “obese” – will be putting their short and long term health in jeopardy in the hopes of scoring more points than some other dudes, and winning jewelry.

If we really believe that people who don’t prioritize their health should be treated poorly and denied positive media representation, then I’m pretty confused here:

First is this incredibly long list of injuries.

And what about the massive impact of concussions on players future lives (and the NFL cover-up thereof.)

Or the fact that the rate of bankruptcy means that taxpayers will likely pick up the cost of most of the future healthcare they’ll need.

Football players are given massive media exposure despite the fact that they are clearly not prioritizing their own health.

So if we think that people who don’t “prioritize their health” are poor role models and shouldn’t be represented positively in the media, what is this whole Superbowl thing about?  Where is the insistence that football players aren’t good role models because they aren’t prioritizing their health? Where are the calculations about how expensive football players (from Pop Warner to Pro) will be – not just with sports injuries while they play, but with the fallout from concussions, and the constant pounding their joints take? Where is the WON’T SOMEBODY THINK OF THEIR KNEES hand-wringing?

Where are the calculations of how much money could be saved if instead of playing football those who participate just walked 30 minutes a day 5 days a week?  Where’s the government-sponsored “War on Football Playing”? And all of that despite the fact that body size is complicated and not entirely within our control and we don’t have a single study where more than a tiny fraction of people were able to change their body size, but playing (or not quitting) football is absolutely a choice.

To be clear, people are allowed to play football. My point here is that this whole “It’s because of fat people’s health that we treat them badly” thing is just a crappy justification for size-based discrimination, and it’s long past time to stop using healthism and ableism to justify sizeism, and to end all of them instead.

Did you like this post? If you appreciate the work that I do, you can support my ability to do more of it with a one-time tip or by becoming a member. (Members get special deals on fat-positive stuff from myself and other cool businesses, a monthly e-mail keeping them up to date on the work their membership supports, and the ability to ask me questions that I answer in a members-only monthly Q&A Video!)

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!  (Members get an even better deal, make sure to make your purchases from the Members Page!)

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/2Bgb4CE

Friday 1 February 2019

Photoshoot Friday – My Fat Positive Session with Lindley Ashline

Ok, let’s start here: Photoshoot Friday isn’t so much an actual thing as an excuse for using alliteration. Which is to say it won’t be an every Friday kind of thing. The name just popped into my head and I couldn’t let go of the alliteration (regular readers readily remember that I’m always all about alliteration.) Photoshoots are pretty far out of my comfort zone, so when Lindley Ashline offered to do this shoot while I was in Oregon, I decided it was a face your fears kind of thing – especially since her commitment to fat positivity made it far less scary.

Lindley is the photographer behind Sweet Amaranth: Body Positive Boudoir & Portrait Photography and she is also the person behind the Body Love Box, a fat positive and intersectional monthly subscription box.

We did three locations around Portland. The pictures in the red dress are taken at the Rhododendron Garden. It was beautiful and freezing cold (for an LA by way of Austin girl – it turns out that the cold weather tolerance I developed in my youth is looooong gone!)

In addition to giving me posing tips (I have talents, but modeling is not one of them) and creating a delightful air of fat positivity around the whole shoot, Lindley would tell me what parts of me weren’t in the shot and let me cover them with a coat – she’s the best!

The pictures of me walking and running are also in the Rhododendron Garden and running around, not to mention wearing pants, helped me keep warmer. Normally I’m not a big proponent of pants but in this case… A million bonus points to Lindley since she was working in those conditions.

Lindley then drove out to the ruins of a stone house. My experience of Portland was that you can fall off any curb and into the woods – there are trees EVERYWHERE. This was no exception – a stunningly beautiful location that was just a few feet off the highway. Though I will say that those feet were straight up a muddy embankment with me lugging my suitcase full of various outfits and other photoshoot detritus, and Lindley having to haul all of her stuff up as well. It was totally worth it and we had fun playing with the existing “furniture” at the site, as well as Lindley’s fabulous blue sequin fabric.

We finished with a little scale smashing in my Fatties Against Fascism Shirt (get your own here!) I’ll let you in on a little secret – because we were on a public street and we didn’t have the supplies we needed to clean it up properly, we didn’t actually smash the scale.

It was an incredible day, working with Lindley was a joy, and I’m thrilled with the pictures. (You can click on them to enlarge if you would like.) Pictures are not authorized for use without express permission. If you’d like permission to utilize the photos, e-mail me at ragen@danceswithfat.org

A million thank yous to Lindley, who is a true professional and a joy to work with! You can find her, and her fab pictures, in all of these places:

Instagram: @sweetamaranth

Twitter: @sweetamaranthus

http://www.sweetamaranth.com

Representation Matters  – Diverse Stock Photos

Disclosures for Transparency:

Lindley gifted the photoshoot to me (Thank you!)  I don’t get compensated for linking to her work, or for any purchases made from her.

Junonia gave me the red shirt from the walk/run photos as part of a campaign that they are working on, these pictures may become part of that campaign. Other than the shirt, I won’t be compensated for the campaign, and I don’t get compensated for linking to their site, or for any purchases made there.

I’m not affiliated with the makers of the Fatties Against Fascism shirts (other than loving their work) I paid full price for my shirts from them, and don’t get compensated for linking to their site, or for any purchases made there.

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 (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/2HMacLT