Why I won't WLS

So I guess this is my version of a Fat Acceptance 101 post. A long talk with a friend over February break helped me sort out most of the thinking, and then an "I believe in HAES but I want WLS because I'm in pain and weight loss will fix it" post and the numerous pro-WLS and WLS-accepting replies thereto -- in a purportedly HAES online group -- motivated me to write it out.

When you strip away the siren song of a cure for whatever ails us (whether that be physical pain, mental pain, disability, etc), this all remains true:

1) Medical science has NO CLUE whether being less fat actually confers the health benefits medical science associates with being less fat, because very little research has been done that effectively proves causation rather than mere correlation. (In other words, we don’t actually know if being thinner is healthier than being fatter.)

2) Medical science has NO CLUE whether making a naturally/genotypically fat person into an artificially/phenotypically less fat person (whether via typical "diet and exercise" or more intensive surgical means) actually confers the health benefits associated with being less fat. (In other words, even if being thinner is healthier than being fatter, we don’t know if that is because of the thinness itself or because of other genetic factors. We don't know if becoming thinner through external means will make you as healthy as a person who is naturally thin.)

3) Medical science has not identified ANY weight loss interventions that are proven by good quality studies to be effective in the long term for more than about 5% of people. This includes WLS. (In other words, even if becoming thinner is healthier, WE DON’T KNOW HOW TO MAKE PEOPLE THINNER. This is key.)

4) Medical science does NOT fully understand the human metabolism and the complex mechanisms by which our brains, hormones, enzymes, digestive system, and other body systems regulate how our bodies use and store the energy we take in. (In other words, it’s no wonder intentional weight loss doesn’t work – we don’t even understand the body systems we are attempting to control!)

5) What medical science DOES know is that our bodies adjust how efficiently we use energy, when and whether to use energy versus store energy for later use, and so on, based on how much energy we take in, how much energy we expend, and who knows how many other variables. (In other words, our bodies are not the same as car engines. The whole “just eat less and exercise more” mantra is fundamentally flawed, because our metabolism is constantly reacting to changing circumstances and changing how it processes fuel accordingly.)

6) Because medical science does not comprehend how to adjust the human metabolism, WLS works on the same general principle as weight loss interventions (giving the body less fuel so that it uses energy from stored reserves, e.g. body fat) but depends on a physical impediment to the body’s intake of fuel rather than a behavioral impediment. (In other words, WLS is just a weight loss diet with a “gun to the gut” in the form of some sort of physical implant or mutilation of the organs that inhibits the body’s ability to eat much volume and/or to absorb the nutrition from what is eaten.)

Yes, it is logical that some of our afflictions may be caused in some way by our larger bodies, and the wear and tear to joints and body systems caused by asking them to work hard transporting our eloquent poundage through life. But given all of the above, it seems clear that this is moot. Intentional weight loss is not an option. WE DON'T KNOW HOW TO MAKE FAT BODIES SMALLER. Diets don't magically work just because we are in pain and are doing weight loss "for our health." Biology doesn’t understand intent.

If we want to feel better, we need to focus on things we can control: eating food that feels good and provides us energy, moving our bodies in ways that build strength and stamina, and getting psychological and emotional support to process the complex and difficult emotions that come with living in pain, living with disability, and being a member of a marginalized and oppressed group in society.

When a car isn't just a car

So a month ago I was rear-ended and my car was totaled. Luckily I am physically fine. A little sore at first but my chiropractor did a great job getting me back on track. Unfortunately, the car search has been incredibly painful as I struggle to find a car that will accommodate my fat body. I have been having dark thoughts about capitulating to mainstream medicine and looking to weight loss diets/surgery/etc.

This week, we got connected with an accessibility place that does van conversions. Not only do they have a minivan that accommodates my fat body in the driver's seat, but I'll be able to load my mobility scooter all by myself without struggle, and have a level of freedom and independence I haven't had for a couple of years!

The downside: the placement of the pedals requires my leg to be straight out from my hip, rather than lolling to the side like it usually does because of my big belly. The muscles in my inner thigh have to work pretty hard to keep my leg in this position, and after a longish (20 min?) test drive I was in a good deal of pain. Everything else about this van is better than any of the other vehicles we've tried, and after much talk and brainstorming we concluded that no other vehicle is likely to be able to fix this problem, nor is there an aftermarket modification that can be done to fix it.

Luckily, I have my resources. I consulted with dear Cinder Ernst the amazing exercise coach, and she thinks exercise can strengthen this muscle group to make the pain less over time. Friend Carole talked up the benefits of the increased independence and freedom this van will give me, and encouraged me to have faith that I can do the strengthening piece.

I go sign paperwork tonight. I'm gonna have a new minivan!

Still struggling to own this disability identity and not feel like I should "just eat less and exercise more" and undo my disability. That sh*t doesn't work - I know the research shows it - and yet the pressure is everywhere!

Trying really hard to turn away those dark weight-loss-focused thoughts and remember that my job is to eat food, stuff I like, as much as I want, and to take small steps with exercise.


So hard! When I hit a major bump in the road like this, especially one that centers around my body size, it is SO HARD to stay on target.

Medical Self-Advocacy (and no weight loss talk!)

I advocated for myself today. I have a tooth that had an inadequate root canal last May and it's causing me increasing pain. My dentist sent me to a specialist, who agreed it needs to be re-treated. At the time it wasn't causing much pain, so when we learned my insurance only covers a re-treatment every 12 months and I'd have to wait until May, I sighed, was a little bit disgusted by insurance running my health care decisions, and put a note in my calendar to call the office in April to schedule.

A couple weeks later, my tooth is really bothering me. So today I called my dentist and asked if they could help me advocate to my insurance company that the procedure really needs to happen sooner. Bad news - they were told it's every 24 months, not every 12! Good news - there is a process to appeal this. My dentist is working with the specialist dentist to have them send the required x-ray images and narrative to the insurance company. It could take up to 4 weeks to review but at least the ball is rolling.

In the meantime, ibuprofen is gonna be my best pal.

On a side note, it's really nice to be having a health issue that no one, but no one, thinks is my own fault because of my weight, nor that it could be solved by weight loss. Being treated for my specific health concern with nary a whiff of a suggestion of drastic weight loss tactics is a novel experience, and one I'd love to be able to get used to!!

Puttin' on the Ritz

I grew up steeped in ideas about good foods and bad foods. Eating good foods (or even better, no food at all) made one a good girl, virtuous, and - eventually, presumably - skinny. Eating bad foods made one a bad girl, gluttonous, and fat with all the most negative connotations of fatness that society allows.

I've worked hard to unpack and (to some extent) unlearn these attitudes. I had a moment today when it really reared up. I realized I feel guilty/bad when I eat Ritz crackers. I remember being told they were full of fat and they were not something we ever had in the house growing up.

I wonder... are they really nutritionally that bad? I almost looked at the Nutrition Facts panel when the thought reared its head. But what would that prove? They are not made of air and cardboard, and they are a processed food, so a glance at the facts and figures is not likely to prove they've got the same nutritional content (or lack thereof) as a handful of celery sticks and shut up the guilt that way. Nope, that's staying within the problematic paradigm. It's not about whether they're "bad" or "good" at all. I've gotta use my intuitive eating and HAES skills and shut that sh*t down.

So...
Fact: In an ideal world, I would've brought a lunch, but I didn't.
Fact: The options to go out and purchase near work, and the time it would take to do so, did not work for me today.
Fact: I need to feed my body. Unplanned fasting is not an acceptable option for me.
Fact: I had Ritz crackers in my desk drawer because they're something I'll eat even when I feel crappy and/or don't feel like eating.

Therefore: Ritz crackers were the right choice given the parameters in place today.  

Take that, tape loop in my head!

The Workout Experiment: Day 10

I woke up naturally, 1 minute before my alarm clock, today! It could be that I actually went to bed before 11pm. It could be that I just happened to hit the sleep cycles just right. Or... could it be that this exercise project is already bearing fruit? Wouldn't THAT be cool... :)

Day 10: Decided to try out my commenters' suggestion of exercising in the morning before my shower. Feeling on a high from waking up naturally, I did 50 seconds before hitting the shower and getting ready for my day.

Feeling good so far... hope I don't hit an energy slump later today or anything. I'll just have to be mindful of how I'm doing throughout the day and see whether am exercise works for me.

PS - This is the first day where I'm putting two cupcake stickers right next door to each other (aka exercised 2 days in a row). I kinda thought today I was due, but it turns out not. Cool!

PPS - the word "exercise" is starting to feel less scary/yucky/OMG-anything-called-exercise-is-gonna-be-hard-painful-and-humiliating and more EMPOWERING. Again... this is all very cool! My mood is on a pretty nice high today!

The Workout Experiment: Days 8-9

Day 8: Luckily it was a planned rest day, as I spent much of the day at the Urgent Care clinic with my fiance, who was eventually transported to the ER and is currently still in the hospital with pancreatitis. (He will be OK... sadly this is what happens when you have severe diabetes and don't take proper care of yourself.)

Day 9: Walked in the door from visiting V at the hospital about 8:30pm, set down the crap in my arms (including my dinner), and went straight to the elliptical. Probably I should've eaten first - especially since hadn't had much in the way of breakfast or lunch either. But I knew if I didn't do it right then while I was still in "go" mode, it wouldn't happen. So... 40ish seconds on Day 9 - check.

Calendar update: I found an adorable printable calendar that's suiting my needs so far. And you can't beat the price tag: FREE. (OK, technically a few cents of paper and ink.)

I was going to use the classic gold stars, but took note of commenter Jeanette's input and decided to use the sparkliest, most exciting stickers I had on hand. And let me tell you... it makes a difference. I get excited to place the next one! (I may or may not be an office supply slash sticker addict.) Not quite sure what I'm gonna do when I run out of amazing glittery cupcake stickers... excuse to buy more stickers, I guess!

Action Shot: December 2012

Here's a link to the free printable for 2012, in case you need December. And here's 2013.

Do stickers on a calendar motivate you? If not, what does?

Deleted Comment

I'm flattered, I think... I have enough readers that I'm now deleting my second unacceptable comment. The first was a concern troll... this one's just downright rude.

I received the following comment on my most recent post:

Anonymous December 2, 2012 12:23 PDM

Why are you taking rest days? You should be doing SOMETHING extra every day, no excuses.

If you always say you're "too tired"/"wanted a rest day" then you're not going to get anywhere.

I will be deleting the SH*T out of this comment. Do I even need to list the reasons why? The use of "should," the scolding/reprimanding tone, the phrase "you're not going to get anywhere." Um... the exercise professionals I trust have told me to start with 3 days a week. Not to mention that telling someone who's taking first tentative steps into a new and difficult lifestyle change that they're DOING IT WRONG OOGA-BOOGA is pretty much guaranteed to be unhelpful/counterproductive.

Jerk.

The Workout Experiment: Days 6-7

Well here we are at the end of Week 1! I feel really positive, and very excited to keep moving forward...

I appreciate all the comments y'all have been leaving. When you tell me your story, even if I don't  take what you're doing and implement it exactly, I still learn from it - learning different ways to think about exercise, different ways to motivate myself, or what's triggering and anti-motivating for me. I am definitely a person who processes ideas best by thinking things through in conversation with others. I guess that's part of why I keep a blog and not just a private journal!

Day 6 was a rest day. I looked at calendars in the dollar aisle at Target (to implement the "don't break the chain" approach) but didn't find any exciting ones. Time to keep my eyes open for a calendar that makes me happy.

Day 7 (today) - got on the machine for about 36 seconds, but went a bit faster than other times. I can feel a pleasant burn in the front of my thighs now, a couple hours later. Nothing debilitating or painful, just a "yup, I moved my body." This is fun!

How do you know when you've hit just the right amount of exercise for your body? What does it feel like for you?

The Workout Experiment: Day 5

So here I was, sharing my Workout Experiment journey in part to bolster my own certainty that taking it slow was the right thing to do... but my inner judgy voice was still secretly thinking 1 minute, 30 seconds on the treadmill was really not enough. Cue Cinder Ernst, fitness coach extraordinaire, who chimed in to say,

"Yay for you. 1.5 min of the elliptical is a big chunk for day 1. I suggest starting w an amount that leaves you feeling good all over, maybe 30 seconds for a few days, then 1 min for a few days etc. You will find if you use the smallest smallest smallest of steps, consistently, your body will start to lean into it."

Thank you, Universe, for all these wonderful teachers and wise women I have been able to bring into my life! Today, without even resting after bringing in groceries - because I knew if I stopped moving I'd hit they hay and not wake up til morning - I did 35 seconds on the elliptical. And it was enough. And the next time, I might do a minute-plus. And hey - the time after that, I might do 30 seconds or a minute again.

One thing I'd fallen into without even realizing it was thinking that each session had to be longer than the one before. Which, once it was brought up to the level of conscious thought, was ridiculous. Consistency is kind of ridiculous to ask of my body - especially when nothing else in my life is consistent! I will have had different days, different levels of activity, different levels of stress... Of course I would have different capacity to exercise. Thanks, Cinder - I needed that!

Edited to add: I know Cinder's point was really to start smaller, more so than the insight I ended up getting to about consistently increasing the time not being the only measure of success. But it was Cinder's point - or rather, her voice of reason saying 1.5 min was probably too much for my body - which allowed me to tune in and really think through my expectations/assumptions. So it's really two lessons here on Day 5: 1) start EVEN. SMALLER. and 2) don't expect the seconds to only increase. They're gonna move depending on how my body feels, and that's OK too. 

The Workout Experiment: Days 2-4

When we last left our brave heroine, she'd done 1.5 minutes on her exciting new (well, new to her) elliptical machine. There was much cheerleading and many motivational comments were made. And then you didn't hear from her for 3 days. Heh. I don't think it's realistic for me to post every day on this, so I'll do summaries whenever the mood strikes.

Day 2 (Monday) - Went to my parents' old house to pick up odds and ends of my leftover stuffs that had been buried in the attic. Physical labor up and down the stairs, and emotional labor sorting 3-4 boxes of childhood teenagehood papers and momentos. Got home late, ate dinner late, gave myself a pass on the elliptical.

Day 3 (Tuesday) - Had a 1.5-hour meeting with a wedding vendor directly after work, then to a late dinner, making it home about bedtime. Didn't end up going to bed anything like bedtime, but I was worn out from a long day nonetheless. I'm not willing to call this a fail, because I was thinking of getting on the elliptical but was literally falling asleep in my chair instead. Can't explain why, but it feels like an acceptable 'pass' so I'm giving it to myself.

Day 4 (Wednesday) - Was damn well gonna get on the elliptical today. But... the child I mentor on Wednesday nights looked at me with hopeful eyes and informed me that Christmas In The Park was up, and could we go, please? So we walked around browsing nomadic carnival rides and nostalgic-with-a-side-of-creepy animatronic displays. I carried with us the folding chair I always keep in the car, and took lots of breaks. Send her on a ride, sit and rest. Let her play a carnival game, sit and rest. Make her watch the perpetual motion machine in front of The Tech Museum for way longer than she wanted to because a) it's awesome and I wasn't done, and b) sit and rest. It was frustrating to need so many breaks, and painful even with the amount of breaks I took. I prolly didn't get my heart rate up enough for long enough, but I did move my body. And I broke a sweat. (Tho that could've been the pain more than the exertion. Not totally sure. But I digress....) It totally counts as exercise, and yet on the ride home I felt more motivated to get on the elliptical than I did yesterday or the day before! I didn't let myself, though, because my back is not happy from our outing this evening and I want to make sure to give it rest.

A commenter on my Day 1 post suggested the "Don't Break the Chain" model for momentum and motivation, and it definitely appeals. I want to be forming the habit of thinking every day, "have I moved my body today?" HOWEVER, the answer to that question is sometimes going to be "no" or "not in the manner I had planned" -- and that HAS TO BE OK. There are just gonna be days when life gets in the way and I give myself a pass, and/or I do some other activity that "counts" instead.

I may have some thinking to do about what, if any, ground rules I should lay for myself in terms of how many passes, in what circumstances, and/or what alternative activities "count." But on the other hand, that sounds like work. Besides, so far I'm feeling like I'm aimed in the right direction, so I think I'll continue just letting my gut guide me, at least for now. If in a few weeks the momentum is gone, I'll look at taking a less organic and improvisational / more structured and rules-y approach.

Ooh...in the meantime, I need to print out a calendar for the month of December so I can start giving myself big red X's (or perhaps shiny gold stars, cause... stickers are totally motivational!).

If you have a workout/exercise/movement routine or goal, how do you decide how many chores, how much walking at the mall, how much pickup soccer with your kids at the park, etc. is a reasonable substitution for your regularly scheduled exercise activity? Would you recommend your approach for a baby beginner exerciser, or modify it in some way?

Fat Poz Zone

Howdy folks,

Just a friendly reminder that this is a fat-positive zone. Or - if you can't quite manage that - at the very least, a weight-neutral zone. No discussion of intentional weight loss is welcome here, even if "you're just concerned about my health." That's called Concern Trolling (1) and it's not welcome here.

But how can you support me, if you can't tell me to lose weight, or share your inspiring story of how you lost half your body weight and have kept it off for 10 years and will sleep better at night knowing you've done everything you can to avoid the cancer that killed your mother? Read on, friend... read on.

A) Encourage me in my efforts at adopting weight-neutral, HAES(r)-based strategies for managing and improving my health and encourage me in those BEHAVIORS rather than in some perceived or "should" weight-loss goal.

• Studies abound which show that the positive health outcomes commonly attributed to weight loss will be achieved regardless of weight loss, if the healthy behaviors (movement, nutritious eating, etc) are adopted. (2)
• Studies also show that when weight loss is the motivating factor to exercise/eat healthfully, motivation tapers and the behaviors are abandoned when weight loss is not achieved or plateaus. On the other hand, when "feeling better" is the goal, incremental improvements provide positive reinforcement on an ongoing basis. 

B)  Even if it seems like weight loss might be the only way to improve how I feel, or if you cannot bring yourself to believe that my weight is not a causal factor in how I feel, resist the urge to suggest weight loss. Long-term, sustainable weight loss is just not possible for the vast majority of people.(3)

• The reality that doctors and diet programs fail to acknowledge is that somewhere around 95% of weight-loss diets fail. So by having weight loss as a goal, I'm very likely to be setting myself up for failure. 
• Still believe that I should be striving to be part of that 5%? Fine. Keep it to yourself, and see Point 1 -- you can encourage all the healthy behaviors you think I should be doing, and you are welcome to think to yourself that they'll lead to weight loss if that helps you support me. (Though hopefully you'll go out and read the research for yourself so you can continue to support me even when I don't "succeed" at becoming thin.) 

C)  For me personally, the suggestion that I need to lose weight is particularly harmful due to my medical history.

• If you really care about me, you will resist the urge to suggest weight loss for the simple and very personal reason that I have a history of eating disorder and the suggestion of weight loss from people I care about is very likely to bring on a relapse. I am tired of throwing up, depression, anxiety, etc. Seriously tired.

Footnotes: 
(1) On Concern Trolls: 
http://danceswithfat.wordpress.com/2012/01/11/dont-cry-for-me-well-meaning-concern-troll/
http://fatheffalump.wordpress.com/2012/01/04/genuine-concern-vs-concern-trolling/

(2) On positive health outcomes independent of weight loss:
http://thinkmuscle.com/health/obesity-health-metabolic-fitness/
http://danceswithfat.wordpress.com/2011/01/19/why-health-at-every-size/

(3) On long-term, sustainable weight loss being highly unlikely for the vast majority of people:
http://thinkmuscle.com/health/obesity-health-metabolic-fitness/
http://danceswithfat.wordpress.com/2012/04/21/for-fat-patients-and-their-doctors/
http://danceswithfat.wordpress.com/2012/06/12/do-diets-fail-or-do-dieters-fail/

The Workout Experiment: Day 1

I suffer from chronic back, knee, and hip pain. Even more frightening, it's been getting steadily worse, and increasingly limiting to my day-to-day activities over the past year or so. It's gotten to the point that I can't go to an amusement park or museum, can't go shopping unless there is an electric courtesy cart, can't do SO MANY THINGS. A couple of weeks ago, I reached a crisis point. I was tired of being in pain all the time, terrified of the speed at which it was getting worse, and desperate to figure out what to do about it.

So I dragged my fiance to a local sports equipment shop that carries second-hand and consignment exercise machines. Amazingly, they were far more affordable than I'd thought, and we found one we really liked AND that would fit in the small available corner of our living room. Sold! It was delivered last Tuesday, but with the craziness of getting ready for Turkey Day and then being out of town, today was Day 1.

I've decided to chronicle my efforts, for several reasons. 1) so that I can look back and see how much progress I've made, 2) in hopes that sharing my efforts and getting cheered on by my community will help keep me motivated, and 3) because I believe it's important that we all serve as role models for each other in honoring where we are and celebrating our efforts... even if - perhaps especially if - we're afraid that we'll be judged that our efforts aren't good enough, or afraid of revealing our "shame" at how small our abilities/accomplishments are at first. So, without further ado....

Day 1: I walked on the elliptical for 1 minute, 35 seconds at the lowest resistance and slowest speed I could do while still getting the pedals going in a rhythm. At the end of that time, I was breathing hard enough to be uncomfortable and could definitely "feel the burn" - particularly in the front part of my thighs. Happily, neither my back nor my knees were uncomfortable. When I stepped off the machine, I did feel a little unsteady on my feet and needed to sit down. But recovery was fairly fast. Given that I have little/no experience of exercise since middle school PE torture, I don't feel well calibrated as to how I'm supposed to feel and how far I'm supposed to push myself, so I'm erring on the side of caution. Nothing's more likely to dis-incentivize me to keep up this project than pushing myself too hard and ending up in a bunch of pain.

So there ya go. Day 1. Go me! :)

Apparently fat causes uterine cancer...

The following is a letter I sent to the Fat Studies Group in hopes that I can get some answers on this issue. I wanted to go ahead and post it here, because I'm sure anything a doc has told me, other docs have told other fatties. Any helpful responses I get, I'll post here as well (if I can get permission) or at least summarize so that others can benefit from whatever wisdom the Fat Studies Group members are kind enough to share.

Also, hey, I know there are plenty more smart and wise people in the world than can possibly be contained in one Fat Studies Group (even as awesome as this group is)! So if you have thoughts/wisdom/knowledge to add, please do! :)

TO: Fat Studies Group
DATE: 11/16/2012

Hi folks,

I need your wisdom and your knowledge, please. I am in a great deal of distress over some medical stuff and accompanying weight blaming, and I need to arm myself with information in order to navigate my way through.

As have so many of us, I have spent a lot of time, energy, and resources working to unlearn the paradigm that fat=health risk and that lose weight=better health outcomes. I know to ignore docs when they tell me to lose weight to improve my blood pressure, cholesterol, prevent diabetes, etc. I know it's about healthy behaviors, not a weight or a BMI on a chart. I know that when the myriad medical voices and social pressures get too overwhelming and gastric bypass starts to sound like a magic wand, I need to turn to my support system and recharge and remind myself that it is SO NOT the answer. I am a believer in Fat Lib, HAES, the whole shebang.

And yet... I've gotten a new argument thrown at me that I haven't encountered before, and it's thrown me for a loop. Apparently now I need to lose weight or I'm going to get uterine cancer. Let me 'splain...

Two victories in one little gym trip = WIN

Making this a quick, run-by blogging as I have much to do today... but had to set down in text and in my memory the awesome experience I had this past Saturday morning:

I went to a new-to-me YMCA, and for the first time in my life was totally comfortable walking around in the locker room nude. There were so many diverse bodies (though mostly age diversity, no other super size gals were there at the time I was), and everyone was so naturally at ease, that it was easy to be at ease too. Of course the years of work and struggle I've put in learning to be happier in my own skin probably helped too. So I'm taking a moment to revel and feel proud!

Another reason to feel proud... We had meant to go for the deep water aerobics class, which I thought was at 8:30. However, it was actually at 8am, and already well underway when we arrived... but instead of giving up, I grabbed my workout buddy (aka fiance) and dragged him to the shallow pool where we could do some water walking instead. 

PS - I am painfully aware that this is not my best writing. More along the lines of a FB status than a "real"/"good enough" blog, says my inner critic. So please be gentle and support me in taking a risk in posting it anyway, because I don't have time today to refine it to where I'd like it to be. And posting something rough is WAY better than waiting until I can post something "real", which will lead to never posting anything, and losing this great moment from my memory!

31 Days of New Year's REVolution Challenges

I'm posting the 31 Days of REVolution because life has gotten hectic and I don't want people to go without if I have another conflict and miss a day like I did Friday and Saturday (bad Amanda! I feel so bad for letting people down...).  If you don't know what I'm talking about, go to the FB Event page (see link below!).

31 Days of REVolution Challenges

Join us in 31 HAES / New Year's REVolution Challenges for the month of January. Join the FB Event (http://www.facebook.com/event.php?eid=190278547652738) to keep up the excitement and stay informed on new developments!

1. 1/1/2011 -- New Year’s REVolution kickoff day!
2. Dance to the music you love best today!
3. Count clouds instead of calories today!
4. Tell someone they look beautiful or handsome today!
5. Take the first step towards finding a fat-friendly physician today! (You could start with the Fat Friendly Health Professionals list at http://www.cat-and-dragon.com/stef/fat/ffp.html).
6. Today, think of one positive/loving thing about a part of your body which you usually dislike and/or ignore!  (For extra credit, I’ll share this insight with someone you can trust to appreciate it, or journal about it.)
7. Move for the joy of it today!
8. Let go of ideas about “good” and “bad” foods today, and simply eat what your body craves!
9. Have a spa day today! Either go to a day spa to be pampered or make your own day spa at home with manicure, pedicure, hot bath, facial, etc.
10. Stand and sit tall today! Hold your head high and show the world beautiful posture.
11. Read a HAES-positive article today, such as Dr. Jon Robison's article, "10 Things You Can Do Right Now To Ease Concerns About Your Weight And Improve Your Health" (http://www.welcoa.org/freeresources/pdf/10thingsyoucandorightnow.pdf).
12. Today, try out a movement or exercise activity you haven’t done in a while!
13. Have yourself over for dinner today! Make some wonderful food, light candles, put on a dressy outfit and some relaxing music, and really savor every bite.
14. Put on some fabulous new shoes today (even if you’re just trying them on in the store)!
15. Today, spend a few minutes alone, in front of a mirror, look yourself in the eyes, and notice the thoughts that pass through your mind. (For extra credit, speak an affirmation such as “I accept myself just as I am,” or “I am beautiful, good, and worthy” to your image!)
16. Visit a fat acceptance, fat fashion, or body positive blog today!  (Find links to dozens of fabulous, fat-positive blogs on the 2011 New Year’s Revolution Resources page at http://2011revolutions.blogspot.com/).
17. Enjoy a meal with someone you care about today!
18. Find a few minutes to play today!
19. Today, weigh the merits of foods not only by how nutritious they are, but also how delicious!
20. Pick up the phone today and make that medical or self-care appointment you keep meaning to schedule!
21. Wear something that makes you feel sexy and delicious today!   
22. Enjoy what you eat and eat what you enjoy today!
23. Go for a walk or a hike and enjoy nature today!
24. Go through your closet today, and get rid of everything that doesn't fit or doesn’t make you feel good when you wear it!
25. Today, give loving attention to a part of your body which you rarely pamper!
26. Borrow or buy a fat-positive book today! (Find tons of fabulous book suggestions, both fiction and non-fiction, at the 2011 New Year’s Revolution Resources page: http://2011revolutions.blogspot.com/).
27. Tune in to what your body feels like before, during, and after you move it today!
28. Eat a nutritious and satisfying breakfast today!
29. Write down five things you appreciate about your body today!
30. Hug somebody today!
31. Spend time today thinking or writing about how to continue your New Year’s Revolution through the rest of the year 2011!

Self care... it's a right, not a privilege

The New Year's Revolution Challenge for Thursday, January 20, is: 

Pick up the phone today and make that medical or self-care appointment you keep meaning to schedule!

When we don't feel good in our own skin, or we have had the experience of being humiliated, lectured, and scolded time and time again by medical professionals, or we feel ashamed of parts of our bodies, it's easy not to feel worthy of, or entitled to, medical care or self-care or those little physical luxuries like massage or pedicures. 

I'm here to remind you, and myself too, that we are all entitled to compassionate medical care and decadent pampering. Our bodies do not disqualify us! I have finally, after 10 years of searching, lined up a Primary Care Physician and a pedicurist (two of my most crucial care providers - more on why pedicurist is on that short list later!) that make me feel I can get medical care when I need it, preventive care before I need it, and regular pedicures so my chronic ingrown toenails are kept under control - and my feet look pretty and make me feel all girly and happy.

It actually takes two doctors to make one Primary Care Physician to see to my needs. First, there's my official PCP - a family medicine physician I'll call Dr. H, who practices at the local giant non-profit full-service medical clinic (think Kaiser, but local not national). Dr. H is a lovely woman, and seems to care about me deeply. I like her, too, and always ask about her kids and really feel I have a relationship with her. Unfortunately, I've been seeing her for years, and despite trying again and again to bring her up to my HAES standards, she can't or won't get on board. When I tell her about problems she doesn't know how to solve for me with a pill or a needle, she resorts to recommending weight loss because she's so desperate to do something to help me. I even had her talk to my HAES-expert therapist, and all Dr. H got from it was "Dr. B thinks you should exercise, too." Uh-huh... not exactly the full picture of Dr. B's explanation of HAES.

So why do I stay with her? Well... it comes down to the devil you know. I considered leaving - actually tried another doc - and the new one was WAY worse than the old. She actively pushed the issue of WLS! So I did some soul-searching, and decided that I just didn't have the sanity points in my life (or the money or the time to take off work!) to try meeting with a dozen - or a hundred - possible PCPs in order to find the one in a million who truly 'gets' HAES. Or more likely, is incrementally better than Dr. H but still not the HAES guru of my dreams. In the meantime, I've thrown away a person who truly cares about me and my health and happiness, who has a (admittedly major) blind spot but is otherwise really helpful and good to me.

The reason I'm able to settle for less than perfection in my official PCP is because I have another person on my team. I've been working with a naturopathic doctor, Dr. J-L, for the past six months or so. She, too, is less than my perfect HAES guru. (What can I say? I have high standards...!) But she's less indoctrinated in Western medicine, obesity-epidemic-booga-booga than a standard doc - to the point where she understands that a "morbidly obese" person such as myself can also have an eating disorder, and because of that understanding, she will not cross the line and give me weight-loss focused nutritional advice. In fact, she's so careful that several times I've had to explicitly say, "Please, go on... I'm totally open to your advice on nutrition. The only thing I don't want to hear is calories or pounds. General nutrition guidelines are welcome!"

So after one too many weight-loss discussions with Dr. H, and the terrible WLS discussion five minutes after meeting Dr. E (that's the new potential PCP I met with once - the 'E' is for evil!), I went to Dr. J-L and proposed a deal. I told her I'd like us to agree that as far as the two of us are concerned, she's my *real* PCP, and Dr. H is my Western Medicine Liason. We can't tell Dr. H this, of course. But I realized that if I 'manage' Dr. H by avoiding talking to her about things that will trigger her fears and stereotypes about "obesity" (back pain, knee pain, foot pain... things she associates with curing by weight loss, or has no good way to help with other than prescribing weight loss), she can give me great care on other issues, the kind Western medicine is good at (sinus infections, PAP smears, etc.). And now, I have Dr. J-L to help me with those issues Dr. H isn't so good at, so I had the luxury to do so.

The upside? Dr. J-L is helping me feel better on a day to day basis. Dr. H is there to prescribe me antibiotics when my sinuses go haywire. Everybody wins.

The downside? Dr. J-L isn't covered by insurance. Not even a little bit. And I have good insurance through work! And of course, I still don't have my HAES guru. Or rather, I have many HAES gurus, but none of them is my PCP.

But hey... it's working for me. At least until I come up with something better. Now if you'll excuse me, I need to plan my next pedicure.

Vive la REVOLUTION!

Well, I'm back. I was gone a little longer than the month of November, and I don't even have 50,000 NaNo words to show for it. I have no excuse other than life/I got busy/lost momentum/etc. - which is really no excuse at all!

But then again, I have been working hard at the New Year's Revolution. It started back in early December.... Marilyn Wann proposed that we (the Fat Studies List/the HAES and Fat Poz community(ies)) work to create a movement that would go viral on social media to spread the message of New Year's REVOLUTION rather than resolutions - love your body, don't buy in to January pressures to diet/self-hate, and so forth.

So throughout December, I was hot and heavily involved with brainstorming with the fabulous folks of the Fat Studies List on exactly what and how we should do for this awesome FB/social media event. I gathered lists of resources, blogs, books, and daily HAES challenges and compiled them, and other folks created images, took my list and turned it into a fabulous webpage (see http://2011revolutions.blogspot.com/), blogged and Tumblr'd and Tweeted out the wazoo, and so forth. It's been quite an affair, and I'm extremely proud of my role in the whole shebang, and flattered and humbled by the amazing group of people I have the privilege to work with. I mean, who'd'a thunk I'd count such luminaries as Marilyn Wann, Deb Burgard, Marianne Kirby, and so many others as friends and colleagues?? Holy cow, it's so darn cool!!

Seriously... a ton of great people (well, several tons, probably - we're rad fatties after all!) have contributed to this event, and we're already starting to think about how to carry the banner on into February and beyond.

Visit the website (again, it's http://2011revolutions.blogspot.com/), join the FB Event, (http://www.facebook.com/?sk=events#!/event.php?eid=190278547652738), and keep watching this space to join in the fun!!

Wow, this Marie Claire thing...

Ok, so by now you've prolly heard about the Marie Claire thing. If you haven't, I'm sure you can Google "marie claire fatties" and learn more than you ever wanted to know. Other fatosphere bloggers have already posted tons about it, so I won't rehash. But that's the context if you need it for what comes next...

One cool thing that came out of the MC thing is that someone I've never connected with about Fat Acceptance/HAES posted about it on FB, with a link to a blog railing against the MC article. So I commented on the post:

I invite you to blame the horrible author instead of blaming yourself/your body. I am part of the Health at Every Size and Fat Acceptance movements and I would love for all my beautiful friends to love themselves just as they are. ...

If you ever are interested in books or blogs or other resources to learn more about these movements I would love to share them.

She posted back that she thanked me, that she had a long way to go on self-acceptance, and that while she hated what the original article writer had to say, said writer had a right to her opinion.  I replied:

She may be entitled to her opinion, but that doesn't make it ok. Just think if someone had written an article about how disgusting they find it when gay people, or Asian people, or disabled people kiss. We'd be absolutely morally outraged. Why is fat different? (I would argue it shouldn't be!)

And very soon after, I received this letter by FB Message (NOT on the comment string, but to me alone):

Hi!

I just wanted to comment and didn't want to seem like I was starting a flame war or anything...

I would argue that being fat is different. I do not agree with Ms. Kelly's sentiment at all, please believe this. But I do, as an overweight person, feel that being fat is different from being different ethnically or sexually, I know, cause I'm Hispanic, too. All I need is to be gay and I would hit the social outcast trifecta!

I am not at all saying we actively make this choice (though, arguably, there are those who do). There are a myriad of issues at hand. Things that we, as individuals have to work through. Things we, as individuals, have to take accountability for. Is it easy? Not at all. That's why it's called work when we seek a healthier life style. But, in my opinion, to compare our fat-ness to say, our ethnic-ness is not a just comparison. At the end of the day, I can diet, but cannot change the color of my skin....

Please don't think me insensitive, because I know well the trials of being overweight in an overly skinny centric culture. What Ms. Kelly wrote was simply wrong, and completely unfair. And made worse by her admission of having been anorexic in her apology.

It is horrible and dichotomous, this society we live in....we make each other feel bad for how we look, yet try to convince ourselves it doesn't matter.

I think people in general are beautiful in and of themselves...regardless of what they look like.

I hope this made some sort of sense....

And again, I'm not looking for a fight, just offering perspective...

I hope you are having a great day.

cheers,
name

I felt weird about getting this message privately/individually. It was from someone I've seen around, but don't know personally. If he feels strongly about this matter, he should post it in reply to mine so that I could then refute it openly. What's the point of sending just to me, unless he's either a) afraid to look mean/afraid more people will agree with me (gawd, I wish!) or b) ambiguous about his feelings on some level, and subconsciously hoping I'll say something that will allow him to accept his own fatness. Now, my knee-jerk reaction was to say, "yes you're insensitive. And weird and a jerk for sending this privately. Never contact me again." Seriously, I typed that. But then I deleted it, took a deep breath, and after some false starts, sent this:

I don't think you're particularly insensitive, however I do think you are (as most Americans are) uneducated on the failure rate of diets. You have bought into the prevailing misconception that we do, in fact, have control over the size of our bodies. And that biodiversity in body shape and size is "different" than other kinds of diversity. Not too long ago, homosexuality was considered completely controllable and an illness, and prior to that, doctors prescribed skin lighteners to enable African Americans to pass as white. These things were seen at the time as controllable, but more education has shown they are in fact genetic and part of human diversity.

I don't want a fight either but I do invite you to get educated on the Health at Every Size movement and the absolutely abysmal success percentages of each and every supposed "diet" or "lifestyle change" out there. Once we acknowledge that the promise of safe and effective long-term weight loss is a false promise and a myth, it is a much shorter step to accepting the diversity of bodies in human society and ending blame and shame. 

Now, if he writes back with more fat hate, he gets blocked. I don't have enough Sanity Points to deal with that any further. But maybe, just maybe, he'll do some reading.

And that, my friends, is my Activism Deed of the Day. I couldn't stand to stay hidden in the closet of FB Private Message Land. So I am sharing it with you.

EDIT: His response, received within minutes of my message, after the jump. I will _not_ be responding. I've spent enough spoons on him. On a positive note, I got a chuckle from the amusing image of people "loosing" weight. "I will loose my weight upon the world..." watch out - it's like a tiger "loosed" from the cage!

Fat Hate, of course

I get so annoyed and sad when people make offhand fat-hating comments. It's bad in a different but equally bad - maybe worse - way than when people who are clearly fat-hating spew their filth. In the case of the former (i.e. MeMe Roth, doctors, talking heads), at least I never trusted or liked the person in the first place, don't take it personally, and don't have any desire to have a relationship with that person. I expected nothing more from them.

On the other hand, when a trusted friend or supposed liberal, intelligent source makes a fat-hating remark, it hits me in the solar plexus. It's a sucker punch. I thought this person/entity was safe, that they 'got it,' that in liking and respecting me and/or in being a basically progressive, right-thinking entity, they were on my side. And then - wham!It hurts on two levels. It underlines how acceptable fat hate is - it's so much a part of the culture it's invisible to the otherwise sensitive, educated people who spew it without even thinking.And it makes me feel like this person I thought accepted me doesn't really love me - since they've obviously internalized so much fat hate.


Recent examples:
FB--
Person A (status update): something cool
Friend of A (comment): jealous
Person A (comment): It's ok, I still love you like a fat kid loves McDonald's. [emphasis mine]

Radio-- NPR Report on how people who use cash buy less junk food than people who use debit or credit. The theory is that this is another example of how using cash is more painful/concrete than using plastic, so we tend to resist impulse purchases. Interesting, weight-neutral tidbit. Until, of course, the newscaster wraps up with the tagline, "So if you want to lose weight, leave the plastic behind!"

Because, 'of course' we fatties are McDonald's-gorging, junk-food-addicted, lazy slobs who would be thin like everyone else if we'd just comply. And of course if that turns out to be false, if we're good little fatties and we try and try but still can't lose weight... they'll be happy to cut out some internal organs to help us conform. But that's another post.

Keep your assumptions off my body

So over the past 24 hours, I've had a catastrophically yucky initial meeting with my (potential, violently rejected) new primary care physician, followed by (admittedly mild, but I'm sensitive to this sort of thing) Facebook drama. I posted on Facebook shortly after I left the office, because I was upset and distressed by the horrific 5 minutes I'd spent with the doctor. Unfortunately, in addition to several supportive comments, one friend (whose partner is a WLS "success story") posted a finger-wagging comment basically scolding me for overreacting, saying that it was probably appropriate for the doc to act as she did. Then, some other rad fatties and allies posted vehemently anti-WLS comments. Which felt good to read, but they in turn prompted the pro-WLS friend to spring to the defense of WLS. All of this in comments that started to feel like a flame war on my FB. It was to the point by this morning where each FB notification was making me feel sick, because I dreaded what it was going to be...

Finally, I decided to respond. But I'd been doing so much thinking that it became far more blog-length than comment-length. So I'm posting it here instead. I'm sure some rad fatties and anti-WLS people will think my position is not strong enough. While on the other hand, my friends and acquaintances who have positive ideas about WLS will probably feel I'm being unreasonable in my resistance. I can't please you all. I can only try to think this through and navigate it the best I can. I am torn, caught in the middle between the hordes and masses of society who think my body is an abomination, a disease to be "cured" by any means necessary, and by the small, quiet voices of fat acceptance and HAES and the tentative reaching instincts of my own body and soul, which tell me that fat is part of my biology and my identity and it's the world that needs to change, to stop treating me badly and seeing me as a problem and an intrusion.

There's so much to respond to in what everyone said on my FB. I agree with the strong negative feelings that many of you have about these surgeries. On the other hand, I understand where my friend who said the distressing stuff was coming from (even though the way he said it really hurt!). I know several "success stories" for whom the surgery was really wonderful and they are feeling great / much improved / it was all worth it / etc. Which only serves to confuse me because I feel even more pressure to accept the pressure of medical professionals. However, I simply must stick to my own gut feeling/intuition/confidence that this is NOT the right path for me - at least right now. I won't say never, cause who knows?

What truly pisses me off about this doc is that, as I said in my initial FB status post, she had met me LITERALLY 5 minutes before stating that bariatric surgery was really my only option. She had not had me fill out any new patient paperwork. It's almost certain that had not reviewed my medical record extensively, if at all, given how overworked clinicians are these days and the fact that I had not scheduled a full physical, just a 15 minute appt. When she walked in, she asked, "What can I do for you today?" I stated that I am looking for a new primary care physician, and she repeated, "But what do you want today," or something. She didn't ask me any questions or move to initiate the getting-to-know-you conversation I was hoping for. So I said that I am looking for a team captain, that I see a variety of specialists for different concerns, including a naturopath, chiropractor, psychologist, occasionally podiatrist. I went on to express that I was seeing her because I am looking for a new primary care doc who will NOT insist on constantly recommending HMR (my medical group's in-house version of Weight Watchers) or bariatric surgery, as those recommendations aggravate my eating disorder and depression. I explained that I believe in focusing on changing behaviors, not focusing on weight (working my way into explaining HAES). But before I could elaborate, she said that that was just it, we can't change behaviors, and that for someone in my "category" the only viable option is bariatric surgery.

Really? You don't want to hear more about the eating disorder I just mentioned? But of course fat women don't have eating disorders, do they? If you have an eating disorder, it makes you skinny. After all, the same thing we diagnose as an eating disorder if you're below a certain weight (severely limiting calories, obsessively planning meals and reading nutrition labels, working out to excess, etc.), we prescribe to fat people, don't we! You don't want to know if I exercise or not, or what I eat, before making such a sweeping statement? But of course not; you know exactly how I eat (poorly) and whether I exercise (obviously not even a little) from looking at me, right? It may be - it probably is true - that I will never eat or exercise "perfectly."  But you don't even ask the questions??? It was blatantly clear that this woman thought she knew everything relevant about me just by looking me up and down. And so I told her, "ok, well that's what I needed to know. We're done here." She protested, "But don't you want a flu shot or a whooping cough booster?" "No, I don't want anything from you." Not exactly the ringing, persuasive speech I might craft if I were a character in my own movie... but I didn't cry. I didn't give her that. At least, not til I got to my car.

I have done a lot of thinking on this in the last 24 hours and I've come to believe that my feelings on WLS and abortion are somewhat parallel. In both cases, I believe that everyone has the right to choose to go through that procedure, but it is emotionally complex and has long-lasting physical and emotional consequences and should not be taken up lightly. In both cases I would not personally choose that procedure but respect others' right to make their own personal decisions about what is best for their bodies and their lives. And just as I would be offended by a doctor who recommended abortion just because I was visibly pregnant and single, I am offended by a doc who recommends bariatric surgery just because I'm fat.

Pro-choice folks have the slogan, "Keep your laws off my body." While there is no law that one must have bariatric surgery (though it's getting scarier and scarier in terms of de facto weight loss requirements embedded in ability/non ability to access health care in this country), there is a TON of pressure out there, especially for folks like me who are in the very far right (not politics, math - on a graph, bigger numbers are to the right!) portion of the weight bell curve. So it may not be as catchy, but I say it with gusto:

KEEP YOUR ASSUMPTIONS OFF MY BODY. Yes, I mean you, Dr. And you, well-meaning friend. My body is mine. In this day when fatness increasingly IS a choice (if you believe bariatric surgery is a viable option, which so many seem to), it becomes increasingly difficult to stand up and say, "I am fat. I don't believe thinness is a choice for me. So I am going to live in this fat body" without getting some pretty forceful push-back.

Ok, now I have all sorts of interesting thoughts percolating about how just when we thought people might accept that diets don't work, and therefore fatness really is biological and not a "choice"... in walks bariatric surgery, and in just a few short years goes from experimental to frighteningly mainstream. Coincidence?

But that's a subject for another day... This post is already exceedingly long. Kudos and thanks, if you're reading this. You've made it to the END OF THE POST. Leave me a (positive, no meanies allowed!) comment and you get a gold star. :)