HealthNotDiets Digest, Issue 7, 2019
February 15 - February 21, 2019
As always, if you like what you read here, please support the original author by liking/sharing/following/up-voting/subscribing directly to their feed.
Articles & Blogs
Addressing Medicine’s Bias Against Patients Who Are Overweight
by Rita Rubin
"the overwhelming evidence is that by recommending weight loss to your patient in a primary care appointment, when that’s not what they’re there for, does not help them” CW: this is JAMA so it’s still pretty weight centric
Before you bleat about what's in a lunchbox, check your privilege
by Emma Beckett
“Telling people to avoid processed foods without addressing the drivers that underpin those choices is like fighting a bushfire with a garden hose.”
Anorexia knows no body type — and thinking otherwise can be a barrier to treatment
by Carrie Dennett
"medical complications from severe calorie restriction can be serious at any body weight”
by Kate Grace
“Even in this specific and competitive world, I’ve only hindered myself when I focussed too much on how my body looks, as opposed to what it can do."
CW: account of disordered eating
Death Gave Me A Push
By Deborah, from My Mind My Body
“The illness and subsequent death of my father really put my eating issues into perspective. Food and my weight just didn’t seem all that important anymore”CW: discussion of grief and eating disorder
"I should be able to provide that": How welfare-to-work affects low-income single mother's food provision
by Natalie Jovanovski
“Current welfare policies [in Australia] are forcing mothers to compromise on their own and their children’s nutritional intake, due to a combination of inadequate payments and compliance requirements which make them time-poor.”
Vices of the mind: fake news, conspiracy theories, bullshit etc…
by Richard Marshall
“An epistemic vice is a personal intellectual failing – usually a character trait, attitude or way of thinking – that systematically obstructs the gaining, keeping or sharing of knowledge”
The Women Who Contributed to Science but Were Buried in Footnotes
by Ed Yong
"Women have always been influential in science but their achievements have simply not been given the recognition they deserve....That can be changed.”
That Sugar Activity
by Kelly, of Embracing Nutrition
“The problem with the anti-sugar movement is that fear-mongering and misinformation drive misguided belief-based messages and twisted truths. The human body is complex in biology and genetics as well as our environment it interacts with. The simplicity of the message ‘quit sugar’ or ‘eat less sugar’ neglects to recognise that health is far beyond a single ingredient like sugar.”
As A Psychologist, These Are The Problems I See With ‘Diet Culture’
by Alexis Conason
“When a mom posts seeking weight-loss tips, harming her child is probably the furthest thing from her mind. She is in distress and believes that changing her body will help her feel better. These posts are a manifestation of the ways that women are taught that our value is in our appearance and smaller is always better.”
#MarALard*ss and the Left’s Fat Problem
by Your Fat Friend
“We champion the war on obesity and the childhood obesity epidemic without regard for what our tactics actually do to the fat people — including the fat children — we hold dear. Yes, we have passively accepted scripts that were staged long before our time, but each time we recite their lines, we send a clear message that we don’t respect fat people, and that fat people’s dignity isn’t worth considering.”
Addressing Microagressions During Eating Disorder Treatment: Cultural Humility and Intersectional Views of Our Work
by Robin Hornstein
“The secret of intersectional work is not to have no biases, it is to own whatever biases you have, to explore them outside of [your counseling work], and not to allow them to remain in a dark corner whispering “truths” that guide your clinical work.”
Society insists that laziness makes us fat – now science proves this is baseless bigotry
by Sirena Bergman
“being thin isn’t in fact a sign of virtue or health, for the most part it’s a genetic predisposition, much like eye colour, hair texture or the size of your feet.”
Landmark study to track gay and bisexual men's attitudes on body image
by ABC News Breakfast
"Findings from Gay Bodies Worldwide will transform our understanding of the psychology of male physical appearance and will help us develop cutting-edge treatments for gay and bisexual men with life-threatening body and eating disorders”
'Change Clothes To Fit Women. Don't Ask Women To Change To Fit Clothes,' Says Pari Passu
by Virgie Tovar
“One of our models who’s on our site, the first time she came into our office to try on clothes she started to cry. She said, “I’d never been able to put on clothes at this size that closed properly, that feel so good. I feel like these clothes were made for me.” We knew were onto something at that moment.”
Research & Clinical Practice
Dieting and weight cycling as risk factors for cardiometabolic diseases: who is really at risk?
by Montani, Schutz and Dulloo
Dieting is not an innocuous pursuit.
"findings from studies of experimental weight cycling have reinforced the notion that fluctuations of cardiovascular risk variables (such as blood pressure, heart rate, sympathetic activity, blood glucose, lipids and insulin) with probable repeated overshoots above normal values during periods of weight regain put an additional stress on the cardiovascular system. As the prevalence of diet-induced weight cycling is increasing due to the opposing forces of an ‘obesigenic’ environment and the media pressure for a slim figure (that even targets children), dieting and weight cycling is likely to become an increasingly serious public health issue"
Montani, J‐P., Yves Schutz, and Abdul G. Dulloo. "Dieting and weight cycling as risk factors for cardiometabolic diseases: who is really at risk?." Obesity Reviews 16 (2015): 7-18.
Note that even in this paper they have referred to 'unhealthy weight control behaviours' in order to try to separate them from 'supported weight loss' by a health professional. I would argue that there is no material difference to the psychological or physical impact of dieting whether it's recipe is medically supported intermittent fasting or a self-induced starvation diet. Even with medical supervision, if the stakes are high people turn to starvation, purging and/or laxatives in secret.
Either way, repeated periods of starvation are not great for human beings, no matter their body size.
Soapbox & Shareables
There has been a shift in weight-related research from using the rationale that weight loss will confer benefits for risks of hard endpoints/outcomes like heart attacks and diabetes to the weight loss itself being the meaningful outcome.
This amounts to shifting the goalposts and then forgetting the purpose of the whole game.
The LOOK AHEAD study found that there was no difference in cardiovascular events in their weight loss group versus their healthy lifestyle control group for people with type 2 diabetes. That means that intentional weight loss DID NOT ACTUALLY CHANGE THE IMPORTANT OUTCOMES.
Any study where weight change is the primary outcome and the justification for it is for disease reduction is garbage. They actually need to measure, over the long term, if disease incidence IS reduced. If they can't do that, then it's a colossal waste of time, money and effort.
It's hard to teach an old dog new tricks but we've got to try, especially if the tricks they're doing are placing an undue (treatment) burden on others.
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!
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.
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!
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Want some training in the non-diet approach or unpacking weight science? Resources include books, courses, workshops and handouts: visit www.healthnotdiets.com
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