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Epiphanies 2021: The Dilemma of Body Positivity
Doublethink
Admin, 8th Day Host
I am fat, and I have been the majority of my adult life.
I understand and recognise fatphobia, and how difficult it can be living your life not meeting society’s beauty ideals. Part of this is not of choice, but I have also chosen not to wear makeup or present in a particularly feminine way - and I absolutely believe that is a choice I have the right to make without being abused for it. (Sounds obvious right ? But like many women, when I was younger I had abuse shouted at me in the street on multiple occasions - though now I am middle aged I am largely invisible to that constituency.)
In some ways, I feel that the body positivity movement has been a good thing - people should not be shamed and bullied for their appearance. Much of the variability in your body type is genetic, as is the extent to which your body responses to exercise or your stomach produces ghrelin. My body is almost identical in shape to my grandmother’s. It is also certainly true that people can be healthy at different weights, and the bmi is a long way from being an infallible guide to health status. It is good to be treated with respect and to be able to buy clothes that fit, and see yourself represented in the media as something other than cheap gag.
But.
I have also had symptomatic gallstones, fibroids and developed diabetes. These things run in my family too. To date I have been able to remit and control these conditions, at least partly, only by losing weight and increasing the amount of exercise I take. It is hard, because it seem to take a great deal more effort for me to do that than many of my friends - some indeed who have the opposite problem of making sure they maintain enough weight.
I have been reflecting on this lately because I have recently had to again get very focused on trying to improve my metabolic health. I was also reading Graham Norton’s novel Holding On, it was mildly enjoyable but I realised that I was being put off the book by the main character’s internalised fatphobia - his constant dysphoric comments about how disgusting his body is during his internal monologues. At the same time, trying to improve my metabolic health I have had to put a fair amount of time into not injuring myself in the process. Which led to me reading articles on the internet about the massively high proportion of runners who injure themselves in a year, noticing the bbc news story about how high intensity work outs are linked to MND and the poor guy who collapsed on the football pitch today.
So I suppose I am asking what other people’s experiences have been, how you feel about the balance between seeking health and not being ashamed of one’s body, and the balance of risk between metabolic health and exercise injuries.
I understand and recognise fatphobia, and how difficult it can be living your life not meeting society’s beauty ideals. Part of this is not of choice, but I have also chosen not to wear makeup or present in a particularly feminine way - and I absolutely believe that is a choice I have the right to make without being abused for it. (Sounds obvious right ? But like many women, when I was younger I had abuse shouted at me in the street on multiple occasions - though now I am middle aged I am largely invisible to that constituency.)
In some ways, I feel that the body positivity movement has been a good thing - people should not be shamed and bullied for their appearance. Much of the variability in your body type is genetic, as is the extent to which your body responses to exercise or your stomach produces ghrelin. My body is almost identical in shape to my grandmother’s. It is also certainly true that people can be healthy at different weights, and the bmi is a long way from being an infallible guide to health status. It is good to be treated with respect and to be able to buy clothes that fit, and see yourself represented in the media as something other than cheap gag.
But.
I have also had symptomatic gallstones, fibroids and developed diabetes. These things run in my family too. To date I have been able to remit and control these conditions, at least partly, only by losing weight and increasing the amount of exercise I take. It is hard, because it seem to take a great deal more effort for me to do that than many of my friends - some indeed who have the opposite problem of making sure they maintain enough weight.
I have been reflecting on this lately because I have recently had to again get very focused on trying to improve my metabolic health. I was also reading Graham Norton’s novel Holding On, it was mildly enjoyable but I realised that I was being put off the book by the main character’s internalised fatphobia - his constant dysphoric comments about how disgusting his body is during his internal monologues. At the same time, trying to improve my metabolic health I have had to put a fair amount of time into not injuring myself in the process. Which led to me reading articles on the internet about the massively high proportion of runners who injure themselves in a year, noticing the bbc news story about how high intensity work outs are linked to MND and the poor guy who collapsed on the football pitch today.
So I suppose I am asking what other people’s experiences have been, how you feel about the balance between seeking health and not being ashamed of one’s body, and the balance of risk between metabolic health and exercise injuries.
Comments
I read Michael Mosley’s The Blood Sugar Diet, which was based on the early trials of reversing diabetes through going carb-free and I then lost 10% of my body weight in 8 weeks. My only exercise was 10,000 steps a day and a weekly yoga class - no extreme exercise. I felt much healthier having lost the weight, had far more energy and my breathing and gastric symptoms improved.
I lost more afterwards low-carbing but have put some back on during lockdown and need to lose some more again. But when I lose weight I do it for me and my family, not to meet any societal expectations. I’ve have bipolar disorder for over 20 years and learnt long ago not to care what others think of me.
But at the same time, the health impacts are real. Some studies have shown that whilst young obese people can be healthy, this usually becomes harder to maintain as they become older. I can’t remember which article it was but one piece of research examined young people with high BMIs and they had healthy blood pressures and good health measurements overall but 10 years later these had deteriorated.
Re: exercise injury, I tore an inner thigh muscle doing yoga and was on bed rest in agony for 3 weeks unable to walk. Any exercise can cause injury, even walking.
I'm overweight, and it's entirely my own fault. I eat too much, and don't do enough exercise. Trouble is, I like eating (and the things I like eating tend to be the things that increase the waistline), and I don't like exercising, so whilst I theoretically know how to get back to the shape I'd like to be, it's not very enticing.
When I lived in the UK, I used to cycle everywhere, which was enough exercise to maintain my weight. The two things that were bad for me were:
1. Two consecutive summers where I travelled continuously for work, which meant restaurant dinner and a bottle of wine or so every night.
2. Moving to the US. I'm not hardcore enough to cycle year round here, given the weather, which means that I don't actually cycle at all.
Each of those was worth 20 lbs or so.
I'm a man, though, so there's not nearly so much social pressure on me to have a particular appearance. About the only time I see fat men attracting visible social disapproval is on a plane, where all the passengers are hoping not to have to sit next to the man who overflows his seat.
I now weigh about the same as I did at 24, which is not a good thing. A combination of stress and lockdown saw me eating more, eating crap, and exercising less.
The other thing that has frustrated me over the years, is that I have felt encouraged to believe is that exercise is effective in losing weight - for most normal people it just isn’t. It is good for your metabolic health but burns little in the way of excess calories, you only really lose weight - it seems to me - if you reduce your food intake. In the same way people spent years telling me not to drink coke, and failed to mention fruit juice is high in sugar.
It just isn't. A huge amount of science has said again and again that exercise is great for lots of things about health, but weight loss isn't one of them. It causes very little change in weight.
Which makes it weird that we all have this idea linking weight loss to exercise.
If you want to lose weight, it's diet that has the much bigger impact.
With that out of the way... yes to everything that focuses on health rather than weight in and of itself. But also yes to the points about how for certain things, weight has an impact on health.
I lost about 20kg in 2019. I kept it off for a year, including during working from home, and now I've put about 8kg back on. I don't want to put more on, but that's really because I'm well aware that when I've put it on it's a reflection of my diet becoming crappier, particularly in some times of intense work and stress scattered across the last 8-9 months. Diet in the proper sense of what I eat regularly, not "diet" in the sense of "let me temporarily change what I'm eating and cause my body to completely freak out because there's a famine happening".
If you want to lose weight - whether for health or even for aesthetic reasons - do it. You'll feel good about it. Clothes shopping is exciting. But do it by figuring out changes to what you eat that are manageable and sustainable, and for goodness' sake do it by eating things you enjoy eating.
Meanwhile, exercise for your health. Not for your weight, your health. But find kinds of exercise you genuinely enjoy doing.
Whether it's eating or exercise, we should not be setting up this dichotomy between positive feelings and outcomes that are good for us. Eating well should be enjoyable. Being healthy should be enjoyable. Being driven by guilt about these things doesn't, for most people, achieve good results.
However, I don’t think there is any escaping that being overweight does have a negative impact on health for most people, even for those of us who are genetically predisposed to it (of which I am one). There are negative health impacts for being underweight but this is less of a problem in the UK where obesity is a growing concern. The UK’s poor outcomes for covid are partly due to obesity.
I agree with orfeo, I think it is better to consider diet and exercise as something you do for health not weight, and do it in a way in which is sustainable rather than a punishment. Enjoy the food you eat and do an exercise you can enjoy - that is why I decided to go for long walks instead of intense exercise (I have a genetic joint disorder which means impact is painful). Good for my mental health too. I used to work as a nurse in an obesity clinic and our programme employed a psychologist alongside the dietician and physician. I guess I am lucky in that CBT is a normal part of my life due to my bipolar disorder and I also promote the affirmative model of disability (a model based on valuing and celebrating diversity and community rather than the focus on societal barriers and oppression that forms the basis of the social model of disability) so positive thinking is something that is part of my daily life.
A consequence of pneumonia at 14yrs old (and then again at 43 yrs) led to a frightening health episode and the resultant diagnosis of bronchiectasis.
I have always been “skinny” and was tormented by accusations of anorexia my entire teen life. If I take my eyes off the ball then my weight plummets. Get ill and I can be six stone without taking breath. Illness prolongs further and it goes below.
Due to a lower weight all medications consequently overdose me. Seriously, two paracetamols and I m not fit to be in charge of children or animals. In hospital, All suddenly given meds produced an extreme reaction.
Weight has been the bane of my life.
Other people’s opinion of my weight..... nearly destroyed me. I m just glad there was no social media around when I was a child.
Sorry for this very long rant, as anyone can read I m not quite over it yet
I once asked a doctor of my acquaintance why they don't, she said it was that the determining fact for most meds was the size and function of internal organs like your liver and kidneys - and they didn't vary much. I'm not convinced though.
I argued with a doctor once and requested half the amount of a one off medication.
Received an apology the next day!
But that stubbornness delayed my discharge by 24 hrs.
Rather think there is a marker somewhere in my notes as since that admission I am now Weighed ( if at all possible) upon admission !
A few years ago I found a report in the Journal of the American College of Cardiology which suggested the nearly all the benefits of running in reducing mortality can be achieved with a surprisingly moderate amount of effort. They studied >50,000 people for about 15 years and concluded that "Running, even 5 to 10 min/day and at slow speeds <6 miles/h, is associated with markedly reduced risks of death from all causes and cardiovascular disease."
I like running but I find anything more than a couple of miles uncomfortable, boring, and time consuming, so it was encouraging to hear that I could probably get a lot of the health benefit from it without too much inconvenience or risk of injury.
<tangent>As a somewhat related aside, Caroline Criado-Perez's Invisible Woman discussed that drug testing only men is an issue see BMJ article, and there are similar issues for drug testing for dosages in chidren too.</tangent>
That’s encouraging, if I manage to finish Couch to 5k, I may then just stick to a 20 min run without worrying about speed or distance.
Inspired by Dave W I found this: https://bjsm.bmj.com/content/54/20/1195 tldr anything up to 5-7 times the recommended weekly exercise will continue to benefit your health (where it is measured in metabolic minutes https://www.cooperinstitute.org/2017/12/07/using-met-minutes-to-track-volume-of-physical-activity a measure I’d not previously heard of).
NHS recommendations are: do at least 150 minutes of moderate intensity activity a week or 75 minutes of vigorous intensity activity a week
So that would be say, 325 min vigorous (5hrs 40min) or 750 min moderate (12hrs 30min)
No danger of me hitting the upper limit of that !
Re: the protein shakes, I thought it was bizarre that these were promoted as part of the blood sugar diet rather than normal foods as they are not sustainable long term and ignore the fact that eating is a cultural habit. Such a diet also wouldn’t be suitable for my family routine. I did the Mosley diet of 8 weeks on 800 calories eating normal meals with my family but cutting out the carbs for me. I made the diet interesting by putting more effort into fancy salads and vegetable dishes. I even had the odd gin and low cal tonic. Food should be enjoyable, it is one of life’s riches.
It is definitely normal in the U.K., in that the majority of the population don’t fall within the range we are told is healthy.
Conversely, some commentators argue that the challenge to the beauty standard by the body positivity movement is not that extensive https://www.psychologytoday.com/gb/blog/the-fundamentals/201912/is-the-body-positivity-social-movement-toxic
The target issues on the physical side with such health promotion is metabolic syndrome (pre-diabetic), balance and dizziness), falling risk. For mental health, depression, anxiety, symptoms in the post traumatic spectrum.
The links between diet, activity, physical health and mental health are
Drug testing before marketting them involves checking metabolites (what is excreted in pee and poo) and what blood levels are. So unless the drug shows differential metabolism....
In fact, this body positivity was one of the reasons I got fed up with Instagram (other than the algorithm sucks and it's a lot of work to be active on Instagram) the fact that all the dressmaking pattern makers are being bullied into "becoming inclusive" by extending their size range into larger and larger sizes. While at the same time, quietly losing the smaller sizes. And if you do suggest that smaller sizes should still be available it's not likely to end well - a stream of abusive responses suggesting that being smaller is unhealthy. Whether I' would prefer to reduce my exposure to diabetes and those cancers linked to obesity or not, and saying that is seen as fatphobic. So I do understand the dichotomy.
For example, Cashmerette (link) was started as a larger pattern company by an owner who needed larger sizes. The original size range was US 12-28, and Jenny has recently extended that range to a size 32. That covers between a 42" and 62" bust and hip. A recently established company Muna and Broad (link) patterns cover between 40-64" bust, 41.5"-71.5" hip, and the company offers to grade up patterns above their range free of charge. And good on both these companies providing a service, but why does every other pattern company have to be bullied into adding their own Curve (euphemism for fat) range.
Now, having left a sedentary high pressure job with long hours, my weight immediately dropped 2.5 stone from BMI obese to normal range (on a 5'1" frame, it doesn't take much weight to push me between weight guide lines) and has stayed down. The difference was eating home cooked food instead of ready meals, take outs and snacks, getting regular exercise and enough sleep. Lack of sleep is linked to obesity - I found I ate sugar and drank coffee to keep me awake to keep going. I prefer being lighter to protect a damaged knee, which copes much better when I'm lighter, and it means skirts are comfortable in summer without chubrubs,
I decided years ago there was no point in trying to run because I hate it so much and it's not something I will continue doing. I walk, will cycle and swim when the opportunity is there, and do some yoga stretches most mornings. Since listening to the Michael Moseley BBC Radio 4 Just One Thing series* (link) I have added in some of the standing on one leg poses. Yoga because it keeps me flexible and relocates a subluxing hip, which is more comfortable.
*You'll have to listen to the programmes to find out why, but Moseley's list is:
Obviously I am someone obsessed with mental health for personal and professional reasons but I think body positivity would be better addressed by looking at self-esteem generally rather than focusing on looks. And a healthy diet and exercise plays a big part in this. As someone who regularly teaches students who have low self-esteem (perhaps low paid care workers, people who left school at 16 with few qualifications, disabled and vulnerable student) I often have to advise on mental health and resilience. When I advise students to look after their mental health while studying I discuss a range of things they could do and these include a healthy diet and regular exercise as well as a good life balance and sleep.
The early morning walk is an essential part of maintaining my physical and mental health, Ck. Good psychology for lockdown too, as you journey to your workplace.
At the time I was using an app, not to be religious about energy intake but more to understand better the balance of fat/carb/protein. And I remember discovering that this great big plate of a salad with roast chicken, that had been rather enjoyable, still had fewer kilojoules than the slices of bread I would have used for sandwiches.
It’s the combination of that sort of information plus discovering combinations of ingredients that you really enjoy that can make changing your behaviour not just a chore.
For exercise, my preference is walks playing Pokémon Go...
Please note I’m not trying to tell anyone they have to lose weight or anything. I’m just wanting to emphasise again that if you WANT to, it can be pleasant.
When I was at university, I was lucky to mix with a queer feminist community: none of us cared about conforming to stereotypes of how women should look or dress or behave. Because I didn't have much money I learned to cook with lentils and vegetables, walked everywhere, went swimming at a local affordable pool all through summer and considered myself healthy and lucky.
In my early 20s I went on a research trip to East Africa and contracted amoebic dysentery. The symptoms were mild at first and only manifested months after I got home. It took almost two years to get a diagnosis. My weight dropped by two-thirds and I couldn't put it on again, I had bouts of nausea and vomiting, almost constant diarrhoea, couldn't digest dairy and dreaded eating out anywhere.
This was my first prolonged dealing with the medical profession and doctors were extremely unhelpful, not unusual for women reporting with obscure or vague symptoms. Women friends with endometriosis and irritable bowl syndrome (or, more recently, long-Covid) have had similar difficulties. GPs and specialists assumed my problems were stress-related (academic work was suffering because of my illness) and they suspected I might have an eating disorder. My symptoms fluctuated and I had trouble taking myself seriously, I hated sounding like a broken record, so stopped talking about my health to friends. In that climate of not being heard and regarded as somatising or malingering, I began wondering if I was having some kind of emotional breakdown. My body felt like an enemy.
My GP's nephew, a male medical student, developed the same symptoms and his uncle had lab tests done right away that showed amoebiasis. The GP finally realised what was wrong with me, rang me up and apologised. I was diagnosed and treated, the dysentery cleared up.
During that time I became part of another community, those spending a great deal of time in public restrooms due to diverticulitis, stoma bags, digestive disorders, urinary tract infections. I found myself getting to know mothers changing their babies' nappies, breast-feeding, women menstruating and unhoping to find dispensers with sanitary towels. The scarcity of clean free public restrooms in the city was something I had never noticed before. In my head I carried a map of every single public restroom across the city, in hotels, at airports, at railway stations, in libraries. Many businesses refuse access to restrooms and won't hand over keys unless those in need are paying customers, or white or middle-class. Most churches and church halls are closed to the public except on Sundays. In emergencies, I would insist on using staff toilets or men's restrooms, used dirty portable toilets on building sites, carried extra supplies of toilet paper with me when I left the house.
If I hadn't fallen ill, I might never had had to think about the politics of going to the bathroom. Homeless people in cities who had to sleep rough overnight had nowhere to go when public building were locked after 6pm. Unwanted bodies in public places (the homeless, sex workers, those in wheelchairs) were driven away by the lack of public amenities. I'd grown up thinking of body positivity as having to do with educated women and eating or dress choices. That barely scratched the surface.
The poorer the bodies on the street, the less access they have to facilities and the more they are shamed or criminalised about natural body functions and needs. And that's even before we start talking about trans people trying to find a bathroom.
And feeling positive about ourselves should ideally lead to more consideration of issues such as those MaryLouise discusses; how we respect the bodies of others.
@orfeo - please share how. I'm stuck in a "salad is lettuce/other leaves, tomato, spring onion and maybe a bit of beetroot or cold potato" rut. It's boring, and I think the most generous description I could come up with is "worthy". Certainly not especially tasty without the addition of large amounts of mayonnaise (or possibly other dressing, but I'm less keen on the oil/vinegar ones) which rather defeats the object.
I'm also bored as to what to have with salad (as in leaves/tomato/onion) - there's only so much cold meat I want to eat; what do you do if you want to eat something veggie, without having lots of cheese/egg (again lots of cheese probably not so good)... Just veggies leaves me feeling hungry soon after...
Being fit is objectively better than being unfit: you can do more things more easily. For most people, being fit correlates with having less body fat.
I'm supremely uninterested in what I look like (but there goes my privilege again: I'm a middle-aged man, so nobody cares what I look like) but I prefer my body to be reasonably functional.
Before most surgeries requiring anesthesia or abdominal incisions, it's quite usual to postpone until patients lose weight (and stop smoking). We've also had problems getting obese people into MRI and CT scanners.
Part of what is to blame is how people move around communities. Driving versus walking. Elevators versus stairs.
Some research suggests that protein is actually more filling in the long term than carbohydrates, which tend to give shorter boosts of energy.
I find tetrapak gazpacho a good solution to the salad issue.
And from the end of that article:
@ThunderBunk - I was looking for something that talked more about other reasons for body positivity other than just obesity, and found this this article from Very Well Mind (link), which suggests that there are problems with faking that body positivity among other things: and quite a bit further down the article:
It goes on to discuss helping people find a way to be positive about themselves, other than their bodies.
Gwai,
Epiphanies Host
Sorry Crosspost with Gwai.
Several things. One is that if food intake is less than calories expended, weight loss will occur. They are successful in lowering weights of people in long term care. We could call it starvation perhaps, even if I'm trying be neutral.
Diets by themselves- restricting intake of food suffer from the same thing even human behaviour change project suffers from: adherence. We used to call "adherence" "compliance".. In the health promotion stuff I'm involved in, key is proving the right environment for adherence. And yes, it is absolutely about lifestyle re-engineering. -- with the long term care patients, adherence isn't a problem because the care staff control things.
The customer, who had just ordered a large meal, was bragging to her friend on the phone about how well her diet was going, whilst she was in the process of obtaining a meal containing more calories than she claimed she was eating all day.
Which is an example of @NOprophet_NØprofit's 'adherence'.
Personally, I've lost something between 10-15 pounds over the last year, by virtue of not being at work. When I'm at work, I usually eat at work (either in the canteen, or from a nearby sandwich place) because getting up earlier in the morning to make lunch is too much like effort. As a consequence, I eat more than I should, because I don't control the portion size (and once I've got the food, I'm going to eat it.)
At home, I walk to the kitchen and make my own lunch, and it's easy enough not to make too much food.
I have no idea what point you're trying to make, @Leorning Cniht, with your anecdote about someone ordering fast food. You don't know if that person even ate all the food they ordered - it could have been to share or could have been entirely for another person. Or perhaps they really don't know how many calories they were eating, or they were lying to the person on the phone because that person keeps commenting on their food choices. You don't know. This isn't even something you witnessed. But your evident disdain is a great example of fat-shaming. How dare a person who should be losing weight order fast food!
And if everyone interested in such things could take their weight loss tips somewhere else, that would be great. I stay away from the thread supposedly about health and fitness or whatever it's called because when I have looked at it it's too much about weight loss.