HealthNotDiets Digest, Issue 6, 2019
- Fiona Willer
- Feb 16, 2019
- 8 min read
February 1 - February 14, 2019
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Happy reading!
Articles & Blogs
Top 5 Myths about Atypical Anorexia
by Molly In Progress
"The eating disorder treatment and recovery field exists in a world riddled with weight discrimination. A significant amount of those suffering from [anorexia] never receive treatment due to the stigma of weight bias. The truth is that a restrictive eating disorder does not have “a look.” The only difference between a diagnosis of Anorexia Nervosa and Atypical Anorexia is the weight. That is it.”
'Be Anything You Want. Just Don't Be Fat'
by Carrie Dennes
“Parents should know they’re not being given informed consent [for this weight loss trial for adolescents]...This study is unacceptable by scientific standards. But being fat means you don’t need to be told the risks?”
6 “Conscious Uncouplings” to Make for a Better Relationship with Food & Body
by Vincci Tsui
"Using weight/weight gain as a measure of self-care implies that people of higher weight “aren’t taking care of themselves properly,” which is really fatphobia in a nutshell and frankly, total bullshit”
Tommy - Can You Hear Me?
by Elizabeth E. Hall
“the true Elephant in the room is not your size - it’s weight bias and stigma and all the other things that create this cycle of inner churning and create relationships with food and body that are damaging and destructive.“
The plus-size era is over before it began
By Daphne Howland
“there’s a lot of unmet demand from women that are not size 0 to 12, from ages of 15 to 65 — from all women. Younger millennials and Gen Z have given voice to this, but it ripples throughout the entire female population.”
How to Teach Children to Love Their Bodies
by Jill Castle
“It can be hard for children to make sense of the various media messages surrounding thinness, fitness and health, but it’s essential if you want to raise children who appreciate their own and others’ body diversity.”
Weight Gain in Bulimia Recovery
by Elisha Carcieri
“living at a suppressed weight has a significant impact on bulimic behaviors, increasing the likelihood of binge eating (potentially through a brain-based biobehavioral self-preservation mechanism), and subsequently purging.”
6 Strategies for Accepting Your Weight Exactly As It Is
by Margarita Tartakovsky
"It’s really hard to accept your weight in a culture that promotes the idea that with enough dedication, focus and commitment, your weight can (and should) be changed.
It’s really hard to accept your weight when others criticize it, when you’re told your weight is unhealthy, or unattractive, or wrong.
It’s really hard to accept your weight when everyone around you hates their’s, when everyone is trying out the latest diet, the latest detox, the latest workout routine.
Yes, it is really hard.
But it’s not impossible.
I turned to two excellent experts for insights on exactly how we can accept our weight right now.”
Fashion Announces The Existence Of Plus-Size Women
by Kathleen O'Mara
“We admit, we were a little embarrassed to learn that we have not been making clothing or marketing to over half the population of women, but then we remembered that before now, they did not exist.”
Why ‘Don’t Make Enemies’ Is Cowardly Advice
by Vinay Prasad
“your job isn’t to make everyone happy. It is to fix the deep and pernicious failings of our profession. If someone doesn’t like you for doing that, that’s their problem.”
Weight Stigma 101
by Carolynne White
“The first two recommendations from the Senate’s “Select Committee into the Obesity Epidemic in Australia” final report addressed weight stigma. But you wouldn’t know it.”
Risking Fat People’s Lives “For Their Health”
by Raegan Chastain
“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.”
Unpacking Weight Loss Without Dieting
by Vania Phitidis
“If the world was safe for people at higher weights to exist, to get their needs met and to live without prejudice in the world, how many people would be ‘addicted’ to dieting?Probably none.”
The Thin White Men Who Rebranded Dieting As "Wellness"
by Virginia Sole-Smith
"there is still something fundamentally male about the willpower-weight myth. It turns eating—an activity that, at its core, should provide comfort just as much as nutrition—into a contest of self-discipline and deprivation, of pulling yourself up by your Vitamix blender rather than your bootstraps.”
Are Health Insurers Practicing Medicine Without A License?
by Niran Al-Agba
“Decisions made by insurers...have arguably killed patients. But it was only when I got caught in the crosshairs of an insurance company auditor with a bone to pick that I fully appreciated their power to also destroy physicians’ careers.”
What’s BMI or Weight-for-height got to do with your child’s health?
by Eva Musby
"If you’re wondering what BMI means, or ’95 percent’weight-for-height’ and, why there’s a problem with the way these are used, read on.”
Yale study shows that adults take girls’ pain less seriously than boys’
by Olivia Goldhill
“according to recently published research, [women] perceive that a child suffers more if they believe that child is a boy rather than a girl.”
Women Are Dying Because Doctors Treat Us Like Men
By Kayla Webley Adler
“There is inherent bias that makes us undervalue women's symptoms....by the time we make a diagnosis, they are living with the consequences of the lack of care."
Body Image And Type 1 Diabetes
by Erika Arff
“Once I started working with my body, I actually and completely lost all my insecurities towards showing my disease and my robot parts. I didn’t care what people thought of my physical appearance (particularly my size/weight).”
I Couldn't Get the Right Medical Care Because I'm Fat
by Ragen Chastain
“Instead of directly targeting weight loss to help a heavier patient feel better, HAES doctors prioritize positive health behaviors, like healthy sleep habits, movement that brings joy, and nourishing food. Whether a patient actually loses weight isn’t how her doctors measure success.”
Take The Cake: Reframing Jealousy
by Virgie Tovar
"While I was dieting there was no way that I could grieve because dieting keeps the wound of our own self-hating mythology alive and denies that it is a wound at all.”
More than half of today's unicorn health startups haven't published any influential research
by Erin Brodwin
“startups, just like their large competitors, must validate their claims...And the number of highly-valued health startups with little-to-no published science is booming"
I Couldn’t See What Dieting Cost Me Until I Gave It Up
by Savala Trepczynski
“Every day for decades I watched life leave me in a soundless, sad stream; not because I was fat—fat people can live as deeply, fully, and exuberantly as anyone else—but because I was drowning in fatphobia, treating my body and instincts like nasty little horses that needed to be broken.”
CW: includes description of dieting behaviours
Research & Clinical Practice
Effect of breakfast on weight and energy intake: systematic review and meta-analysis of randomised controlled trials
by Sievert, Katherine, et al.
NOTE: I'm not sharing this as a 'what to do' but as an interesting example of 'dietary dogma finally meets its [scant] evidence' (and I like the visual abstract concept!)
For decades we've been told (including dietitians) that eating breakfast is the best way to start the day. The main thrusts of this message have been concentration/weight-control/opportunity-for-fibre.
This meta-analysis (a study of studies) shows that breakfast skippers have a slightly lower energy intake and microscopically less weight gain than breakfast-eaters, on average, in randomised controlled trials (which is just about the least likely environment to capture 'natural' eating patterns).
Point a) Note the disparity between the level of confidence that this message has been communicated to us for decades and the rocky evidence base it has obviously had since the start.
Point b) Look at the TINY sample sizes and timeframes for these studies, most studies included had around 10 people and the longest follow up was 4 months. It is absurd to make weight claims (in either direction!) based on this evidence base.
(HAES dietitians on the other hand, encourage people to get to know what their body is asking for without a weight control agenda, which might be a later start to eating on some days.)
Sievert, Katherine, et al. "Effect of breakfast on weight and energy intake: systematic review and meta-analysis of randomised controlled trials." BMJ 364 (2019): l42.
https://www.bmj.com/content/364/bmj.l42...
Soapbox & Shareables
I love this show and I love it even more now! Spot-on segment about weight discrimination in healthcare and reporting 💪💪
There's now a Change dot org petition to let the organisers of the Fast Track Study know that you think their intervention is unacceptable.Please consider lending your support here - thanks!
https://www.change.org/p/dr-michael-bryden-say-no-to-starving-our-teens-stop-the-fast-track-trial...
Does intentionally starving children sound like a good idea to you? Insisting that they don't eat while they're at school, instead to watch their thinner peers eat freely around them? Replacing their meals with shakes so that even the food they do get to eat is divorced from the social rituals and connections of family meal times?
Well a research ethics committee has decided that imposing this on kids is a-okay. Even after an ethics complaint was received and reviewed, they have doubled down on their decision that the ends are worth the means. Details of the whole horrifying palaver here.
Kids are kids whether they are larger or smaller bodied, and all are considered vulnerable because of their age, maturity and vulnerability to adult coercion. The bodies of 13-17 year olds are consolidating the physiology that has to support them through many decades of adulthood. Energy restriction causes this maturation to delay, falter and undermine strength, function and structure - all things that are necessary to support adult health and function.
Energy restriction is also seriously bad news for concentration and mental health. If a smaller bodied child was doing all of the above 'we' would be highly concerned for them. If a parent was doing that to their child we would consider it neglect. If an institution was doing that to their charges we would consider it abuse. The size of the child is irrelevant, withholding adequate nourishment is unacceptable.
It is not too late to stop this trial.
Please then consider lodging a statement of concern or complaint to the study site near you and your local political members.
Many of us seriously dieted during our adolescence, including me. If my history had been part of this trial the research team would have been thrilled because temporary #weightloss. But what they wouldn't have seen was the 15 years of eating disorder and weight cycling that followed. Every person who works in eating disorder treatment, has had an eating disorder or has had a loved one with an eating disorder will tell you that dieting was their first weapon against themselves. If you dieted during adolescence too, then you KNOW, from your own experience that this trial is likely to not only fail at it's aims, but to promote further life-limiting issues during adulthood. These kids are already at higher risk of an eating disorder, let's not hand them a loaded gun.
Please consider lending your voice to stand up for the rights of these kids.
"I wish we lived in a different world, where what we looked like doesn't matter."
I don’t watch this show but I’ve watched this delightful woman on Gogglebox for years. I’m sorry to hear she’s been struggling with a life-long eating disorder.
Taking a stand against ridiculous weigh-ins-for-ratings will hopefully help us all ❤️
Like podcasts?
How about bite-sized podcasts that you can claim as professional development?!?
I've designed the Unpacking Weight Science Podcast to suit health professionals, health science students and anyone who wants to know more about human body weight, health outcomes, interpreting weight related research and the far ranging effects of weight bias.
The 20-30 minute monthly podcasts unpack different elements of weight bias & stigma, weight research, BMI, health behaviours and weight neutral approaches. Paid subscribers (only $5/month!) get instant access to the previous 15 episodes plus full show notes, reference list, self-test quiz and resource materials for use in practice. This equates to an hour of professional development activity each month :-)
Available for subscribers now is:
'Defining Diet Culture'
Ep 19: Diet culture is something that we frequently talk about as toxic in the eating disorder treatment and Health at Every Size worlds, but what is it? In this episode I unpack what constitutes body and diet culture, what we can do to dismantle it and how it contrasts with the subculture of the fat acceptance movement.
Subscribe now at: https://www.patreon.com/UnpackingWeightScience
and instantly access 15 episodes before the rest of the world!
Episodes 1-5 are now on iTunes!
Search 'Unpacking Weight Science'
to listen to them for free!
Want these 'live'? Then follow me on Twitter (@FionaWiller), Facebook (@HealthNotDiets) and Instagram (@FionaWiller)
Want some training in the non-diet approach or unpacking weight science? Resources include books, courses, workshops and handouts: visit www.healthnotdiets.com
See anything you think I'd like to share or comment about? Post in the comments below or email me at fiona@healthnotdiets.com
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