Sunday, 26 February 2017

Exercise Lowers the Risk for Gestational Diabetes in Women of Size

Image Credit: Stocky Bodies Image Library

Here is the abstract for a prospective randomized controlled study that found that regular exercise starting early in pregnancy can reduce the rate of gestational diabetes (GD) in "overweight" and "obese" women.

The study found that cycling 3x per week for at least 30 minutes each time cut the development of gestational diabetes from 40% down to 22%. That's a pretty impressive difference.

Note that the study did not involve special dietary programs or advice. This study was strictly about the effect of regular exercise on the development of GD. Most studies like this do not differentiate between dietary interventions and exercise interventions, but combine the two under "lifestyle intervention." Yet it's really useful to know what the effect of each is individually. This starts to answer that question.

Another good thing about the study was that it was done with Chinese women. Most GD studies are done on Caucasian women. We need more diversity in GD research, so this is a welcome addition.

Another strength of the study is that the intervention was started early in pregnancy. Most studies start exercise interventions in mid-pregnancy, somewhere in the second trimester. This one started it in the first trimester. It certainly seems logical that starting earlier in pregnancy would result in greater benefits than starting later.

This study also looked at the impact of regular exercise on GD in women of size. Often, exercise and GD studies do not look separately at higher-BMI women. In those studies, there seems to be less preventive impact for average-sized women. I strongly suspect that there is far more impact for higher-BMI women.

One weakness is that the study is fairly small. There were 150 women in the exercise group and 150 in the control group. I'd certainly like to see this study repeated with a larger group. However, it was a randomized controlled study, so that strengthens its findings.

Another weakness was that the groups tended to be more in the "overweight" rather than the "obese" category. I would like to see a study like this done where they see what the effect of regular exercise is differentiated by various classes of obesity.

While the study found slightly lower gestational weight gain among the exercise group, the difference was about 2 kg on average, or slightly less than 5 lbs. Not exactly an earth-shaking difference. Researchers need to focus less on the impact on weight gain, which is a fairly negligible difference in many of these studies, and more on more tangible outcomes like GD rates and other outcomes.

Do note that while the study found slightly lower rates of blood pressure issues, cesareans, and big babies among the exercise group, the difference did not rise to statistical significance. The confidence interval crossed 1.0 for all of these. A bigger study would be needed to know whether regular exercise truly affects those outcomes.

Final Thoughts

Most research around preventing complications in obese pregnancies centers around efforts that combine multiple interventions, but multiple interventions muddy the research waters.

There have been many trials that tried to lower complication rates in obese women through a combination of limiting weight gain, dietary interventions, caloric restriction, and exercise. Results have been highly inconsistent. Some have shown modest results, while others have shown little or no difference in outcomes.

I think they are trying to cast too broad a net. We need more studies that separate out individual factors more carefully so we can examine the benefits ─ and risks ─ more thoroughly. 

Each intervention has potential pitfalls that must be considered carefully. For example, aggressively limiting gain has many risks, including low-birthweight babies and prematurity. As a result, many researchers are re-thinking earlier calls for extremely restrictive gain or weight loss during pregnancy.

Studies on nutritional interventions to prevent GD are a mess, with a recent Cochrane review calling most of the evidence "low" or "very low" in quality. We don't really know if nutritional interventions like a low glycemic diet or caloric restriction are effective or even safe at this point.

Even exercise as an intervention for preventing GD has limited research with uneven quality. As noted above, exercise does not seem terribly effective for preventing GD when considering women of all sizes, but it may be more effective for women of size.

Some research suggests that regular exercise may have other benefits for high-BMI women, like cutting labor length. Still other research suggests that exercise may lower the risk for cesareans in first-time mothers of all sizes. However, exercise seems most useful in lowering the risk for GD. I would love to see further studies done on exercise alone, without caloric restriction or weight gain goals. I would like to see the studies be randomized and controlled, to start early in pregnancy or even before, to have more diverse study populations, and to further differentiate effects by class of obesity.

One potential concern has been whether starting an exercise program in pregnancy would lead to low-birth-weight or premature babies. This kept some doctors in the past from recommending exercise to obese pregnant women, but a recent meta-analysis of studies strongly suggests it does not increase the risk for prematurity.

Exercise is not a magic bullet that will prevent all complications in the pregnancies of women of size, but done reasonably, it does seem like it can moderately reduce the risk for certain complications like gestational diabetes. It certainly seems safer than strong weight gain restrictions or extreme caloric restriction.

I'm all for proactive health actions in people of size, and I think regular exercise is one of the most powerful actions women of size can take for pregnancy.

Let's see more research that more clearly delineates the influence of exercise vs. other factors and reassures us that exercise in pregnancy is indeed safe and beneficial for women of size.



Reference

Am J Obstet Gynecol. 2017 Feb 1. pii: S0002-9378(17)30172-2. doi: 10.1016/j.ajog.2017.01.037. [Epub ahead of print] A randomized clinical trial of exercise during pregnancy to prevent gestational diabetes mellitus and improve pregnancy outcome in overweight and obese pregnant women. Wang C, Wei Y, Zhang X, Zhang Y, Xu Q, Sun Y, Su S, Zhang L, Liu C, Feng Y, Shou C, Guelfi KJ, Newnham JP, Yang H. PMID: 28161306 DOI: 10.1016/j.ajog.2017.01.037
BACKGROUND: ...Regular exercise has the potential to reduce the risk of developing GDM and can be used during pregnancy; however, its efficacy remain controversial. At present, most exercise training interventions are implemented on Caucasian women and in the second trimester, and there is a paucity of studies focusing on overweight/obese pregnant women. OBJECTIVE: To test the efficacy of regular exercise in early pregnancy to prevent GDM in Chinese overweight/obese pregnant women. RESEARCH DESIGN AND METHODS: This was a prospective randomized clinical trial in which non-smoking women over 18 with a singleton pregnancy and met the criteria for overweight/obese status (BMI<28 kg/m2; obese, BMI>or = 28kg/m2) and an uncomplicated pregnancy at less than 12+6 weeks of gestation were randomly allocated to either exercise or a control group. Patients did not have contraindications to physical activity. Patients allocated to the exercise group were assigned to exercise 3 times per week (no less than 30 min/session with a rating of perceived exertion between 12-14) via a cycling program begun within 3 days of randomization until 37 weeks of gestation. Those in the control group continued their usual daily activities. Both groups received standard prenatal care, albeit without special dietary recommendations. The primary outcome was incidence of GDM. RESULTS: From December 2014 to July 2016, 300 singleton women at 10 gestational age and with a mean pre pregnancy BMI of 26.78 ± 2.75 kg/m2 were recruited. They were randomized into an exercise group (n=150) or a control group (150). 39 (26.0%) and 38 (25.3%) participants were obese in each group, respectively. (1) Women randomized to the exercise group had a significantly lower incidence of GDM (22.0% vs. 40.6%, p<0.001).(2) These women also had significantly (2) less gestational weight gain (4.08±3.02 kg vs. 5.92±2.58 kg, p<0.001) by 25 gestational weeks and at the end of pregnancy (8.38±3.65 kg vs. 10.47±3.33 kg, p<0.001), and (3) reduced insulin resistance levels (2.92±1.27 vs. 3.38 ±2.00, p=0.033) at 25 gestational weeks. Other secondary outcomes, including (4) gestational weight gain between 25 to 36 gestational weeks (4.55±2.06 kg vs. 4.59±2.31 kg, p=0.9), (5) insulin resistance levels at 36 gestational weeks (3.56±1.89 vs. 4.07±2.33, p=0.1), (6) hypertensive disorders of pregnancy (17.0% vs. 19.3%; odds ratio [OR], 0.854; 95% confidence interval [CI], 0.434-2.683, P=0.6), (7) cesarean delivery (except for scar uterus) (29.5% vs. 32.5%;OR, 0.869; 95% CI, 0.494 -1.529, P=0.6), (8) mean gestational age at birth (39.02 ± 1.29 vs. 38.89 ± 37 weeks gestation; P=0.5); (9) preterm birth (2.7% vs. 4.4%, OR, 0.600; 95% CI, 0.140-2.573, P=0.5), (10) macrosomia (defined as birth weight above 4000 g) (6.3% vs. 9.6%; OR, 0.624; 95% CI, 0.233-1.673, P=0.3) and (11) large for gestational age infants (14.3% vs. 22.8%; OR, 0.564; 95% CI, 0.284-1.121, P=0.1) were also lower in the exercise group compared to the control group, but without significant difference. However, infants born to women following the exercise intervention had a significantly lower birth weight compared with those born to women allocated to the control group (3345.27±397.07 vs. 3457.46±446.00, P=0.049). CONCLUSIONS: Cycling exercise initiated early in pregnancy and performed no less than 30 minutes, 3 times per week, is associated with a significant reduction in the frequency of GDM in overweight/obese pregnant women. And the decrease of GDM is very relevant to the less gestational weight gain before the mid-second trimester. Furthermore, there was no evidence that the exercise prescribed in this study increased the risk of preterm birth or reduced the mean gestational age at birth.


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Friday, 24 February 2017

Stanford Children’s Hospital Excited To Harm Fat Kids

kids-wlsStanford Children’s center is super proud that “Lucile Packard Children’s Hospital Stanford’s Adolescent Bariatric Surgery program is the first and only adolescent bariatric surgery program on the West Coast to receive accreditation by the American College of Surgeons Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program.”

While I don’t believe that Weight Loss Surgery meets basic medical ethical guidelines for a number of reasons, I’m not going to go into that today because the surgery is legal, and I believe that adults should have bodily autonomy. So whether they want to partially amputate their stomach or their arm (whatever their reasons) it’s their own business.

But that’s not what we’re talking about here.  We’re talking about children whose incomplete brain development can make them incapable of fully understanding the consequences of this irreversible choice (indeed the press release highlights patients talking about being willing to risk their lives so that they can “ride a bike” and “shop for clothes at regular stores.”)

It may be difficult if not impossible for children to understand that they are signing on for a lifetime of restrictive eating and supplementation to balance the needs of a mostly amputated stomach while avoiding malnutrition.  They may not be able to fully process the potentially very serious consequences of failing to follow the post-surgical diet and supplementation program – either because they would rather live off pizza and ramen like the rest of their college friends in a few years, or because they can’t afford (or decide they have better uses for) $125 a month on supplements for the rest of their lives, or for many other reasons.

It’s also highly unlikely that these kids have been fully educated on the dangers of this surgery. They’ve typically only been presented with stories of people who are happy that they had surgery, not given a balanced presentation that also includes people who deeply regret it and desperately wish they could change their choice, as well as hearing from the families of people who died.

Nor is it likely that they are presented with the concept of Size Acceptance (such that they are clear that there are options other than trying to accommodate bigotry and bullies through dangerous surgical interventions) or evidence-based approaches to health like Health at Every Size (since there are thin kids with the same health issues as fat kids, but they are given interventions that do not include amputating most of their stomachs.)

These kids will be left facing the very real possibility of a life full of horrific side effects and malnutrition, and it’s worth noting that if that’s the case doctors are very likely to simply blame the patients and their body size. Those patients can also safely assume that they will not be interviewed, or have their before and after pictures trotted out, for the next press release. Nor will other children likely be told their stories when trying to decide if they should enter adulthood without most of their stomach.

Tragically, there is also the inescapable fact that some of these children will die from this surgery. So instead of riding a bike (which lots of fat people do) or shopping in  “regular stores” (and the fact that a healthcare facility would use the term “regular” in this way shows how deeply ensconced in fatphobia they are,) these children will be dead.

Their parents will have to bury them.  Their family and friends will have to mourn them, they won’t ever ride a bike or shop again. They will be tragic casualties of the war on “obesity,” a war that wants us thin or dead and doesn’t much care which.  Dead children will be the legacy of the war against body diversity and actual health-based (rather than size-based) health interventions.

So before anyone celebrates the fact that people who perform a barbaric (and highly profitable!) surgery on adults are accrediting people who perform barbaric surgery  on kids, let’s maybe have a moment of silence for the children who will be killed by a combination of fatphobia and surgeons.

If you wish to contact them about it you may do so here:

The Lucile Packard Foundation for Children’s Health
400 Hamilton Avenue | Suite 340
Palo Alto, California, 94301
(650) 497-8365 | info@lpfch.org

Samantha Dorman
sdorman@stanfordchildrens.org
(650) 498-0756

Kate DeTrempe
kdetrempe@stanfordchildrens.org
650-721-8527

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Thursday, 23 February 2017

the HAES® files: Unlearning Fat Phobia Is A Lifelong Process

by Melissa Toler, Pharm.D.

After performing at this year’s Super Bowl half-time show, Lady Gaga’s stomach was at the center of some good old-fashioned body-shaming on social media. Super Bowl viewers took to Twitter and Facebook to express their disapproval of her belly fat and suggested that maybe she should have hit the gym a little harder before the big show. It caused enough of a ruckus that she responded on her Instagram account with a brief post to acknowledge that she is proud of her body… and we should be too.

The fact that a woman’s body can draw such criticism is angering, but unfortunately it’s nothing new. We live in a culture that pushes an ideal body type for women; a culture where strangers feel entitled to offer unsolicited comments about women’s bodies. When you put those two things together you get the “The Gaga Incident.”

It’s also indicative of how fat phobia is so deeply implanted into our individual and collective psyches and how much we have to unlearn.

For the past 4 years I’ve undergone my own journey of unlearning the lessons of our toxic diet culture. From a young age I, like everyone else, have been programmed to believe that a smaller body is what women should want. I’ve been socialized to think that it’s perfectly normal to spend most of my time and emotional energy striving for smallness. I’m now at the point where I know with 100% certainty that this is nonsense.

I believe that diet culture dishonors our humanity, over and over again. At times, it’s utterly dehumanizing. I’ve spent the last several months calling out diet culture for what it is: violent, oppressive and harmful to our bodies and minds.

Despite all that, I have to confess: when I saw Lady Gaga’s stomach, an old judgmental voice inside of me resurfaced and said, “Oh my God, why didn’t she cover up her pooch?!” (Yeah, I know. I feel awful just writing those words.) This was the voice that evolved from 25 years of dieting and weight loss obsession. It’s the voice that I’ve worked hard to silence for 4 years. It’s the voice that goes against all of my writing and teaching about body acceptance.

How could I, an advocate for body justice, have such a thought? I found solace in a quote by one of my favorite writers and civil rights activists, Audre Lorde:

“The true focus of revolutionary change is never merely the oppressive situations we seek to escape, but that piece of the oppressor that is planted deep within each of us.”

When living in a racist, patriarchal, capitalist culture, it’s difficult to not have internalized the message that only certain bodies are worthy of being seen. Despite all the blog posts I’ve written and presentations I’ve given, there’s still a piece of the oppressor that lingers in the recesses of my mind.

Unlearning harmful messages is a key to our individual and collective liberation from the body injustices that many of us face every day. The belief that a smaller body is better is so ingrained in our culture that we don’t even notice it. That’s how programming works; it’s part of your operating system.

This is why intentionally deprogramming and reprogramming my thinking has become a daily practice. I can break this process down into the following three steps:

  1. Over time, I’ve unfollowed and unsubscribed from social media accounts, websites, and magazines that reinforce diet culture’s toxic messages. Essentially, I detoxed my environment and eliminated any traces of ‘fitspo,’ diet talk and fat phobia. Initially, it was difficult to let go of things that I’d believed for so long, but it created mental and emotional space to absorb new approaches and perspectives.
  2. Once I freed up valuable headspace, I immersed myself in Health At Every Size (HAES) materials and online communities. The idea that weight and size were not indicative of health or worth were foreign to me and took some time to fully wrap my mind around. Now, the HAES approach is a part of my life and my business.
  3. In the past year, I’ve become more aware of the social injustices that are rampant in our society. I’ve learned that body positivity and acceptance isn’t just about learning how to love our bodies as they are; it’s about justice. Our society has a long track record of marginalizing, stigmatizing and abusing people whose bodies don’t measure up to our standards of beauty or worthiness. I’m continuing to view my work through the lens of social justice.

This has been and will be an ongoing process for me. I believe that diet culture dishonors our humanity by demanding perfection, undermining body autonomy, overriding our body wisdom, and ignoring body diversity.

My initial reaction to Lady Gaga’s stomach at the Super Bowl tells me that there’s more work to do. There are still traces of diet mentality lodged deep within me. Maybe it’s something that won’t completely go away, but I’m committed to doing the ongoing work to disentangle these messages from my mind as much as possible.

Those of us in the HAES and body positive communities want to see revolutionary change. We want diet culture to be burned down to the ground. We want to see weight stigma, weight bias and other dehumanizing body injustices evaporate into the atmosphere.

The work that we do with clients, patients and our communities is important. We have to consistently speak up and speak out. However, our work doesn’t stop there. The oppressor may still be operating within in us, but by doing our work, its impact on our lives can be diminished every day.

 


Melissa Toler Melissa is a non-diet, weight-neutral wellness coach who speaks and writes extensively about diet culture and the toll it takes on our lives and our humanity.

She uses her background as a pharmacist, a certified health & wellness coach, and her 25-year history with dieting in all of her work.

A fierce advocate for body justice, Melissa believes that now is the time for us to make justice a priority in the body positivity community and to reject the status quo. Her mission is to help people connect the dots between our racist, patriarchal, capitalist society and our personal struggles with weight, body image and self-acceptance.



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The #FATANDFREE Movement

Image may contain: 1 person, textI recently wrote about the serious issues with the Body Positive Movement that Lady Gaga’s post-SuperBowl body shaming brought into sharp relief. A lot of people have since asked me for examples of projects that are doing a better job. I think one amazing example is the #FATANDFREE project led by Saucye West*.

Saucye is an extended plus size model and a fat activist. She started the #FATANDFREE campaign to show that “with total body love comes true freedom”

Saucye created this campaign to not just showcase proud, fat, beautiful women, but to show how embracing your body can give you true freedom. The campaign started on New Year’s Day and included photos with women toasting and making a pledge to live fat and free for 2017! The hashtag is now all over social media with amazing pictures of fat folks, and more live events are planned like the sip and shop party that happened at the self-acceptance palace that is Curvy Girl Lingerie!

To learn more you can:

Watch the video below (possibly NSFW)

Check out the press release

Find Saucye online:
http://ift.tt/2luxOHG
http://ift.tt/2mgkuom

Check out the #FATANDFREE on social media

*Disclosure: I received permission from Saucye and Chrystal Bougon of Curvy Girl Lingerie to blog about the project, including the video and the links.  I approached them, and none of us is being compensated in any way for this blog post.

If you have suggestions for Fat Activism/Size Acceptance/Health At Every Size projects that I should let people know about, feel free to leave them in the comments or e-mail me at ragen at danceswithfat dot org!

If you enjoy this blog, consider becoming a member or making a contribution.

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Become a Member! For ten bucks a month you can support fat activism and get deals from size positive businesses as a thank you.  Click here for details

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Book Me!  I’d love to speak to your organization. You can get more information here or just e-mail me at ragen at danceswithfat dot org!



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Wednesday, 22 February 2017

Fat-Shame, Get Fired

civil-debateAlan Linda was a columnist for a local paper.  Then he decided he would jump on the bandwagon of people who write fat-shaming pieces about sitting next to fat people on planes in his “humor” column. The paper apologized for having published the piece in the first place, and then they fired his fat-shaming ass.

Before 27 constitutional scholar trolls leave comments about “free speech,” let me remind you that “free speech” means that Congress shall make no law abridging the freedom of speech.  It doesn’t mean that newspapers are required to publish harmful bigotry and bullying.  Nobody is guaranteed a platform for their speech, and nobody is guaranteed consequence-free speech.  So you can be a fatphobe, but if you wish to do it in writing, you may find yourself without a newspaper willing to help you get your message of weight-based oppression out to the masses.

In fact, we already acknowledge that there are constraints on free speech based on its effects, because if I yell “fire” in a crowded room where there is no fire, my speech can hurt people and I’m responsible for that. So too, articles that seek to perpetuate oppression are harmful,  so good for this paper for refusing to be used as a tool for oppression.

In terms of the ways that airlines and their passengers treat fat people, I’ve covered that here, here, and here, but the bottom line is that fat people deserve the same thing that everyone else already gets, which is transportation from one place to another in a seat that accommodates them.  If the fact that the airlines aren’t providing that inconveniences thinner people as well, then their problem is with the airline, not with the fat people (and tall people, and broad-shouldered people) who are not being offered the same service that the thinner people feel they deserve and should expect, but don’t think others should get.

The larger issue here is that bigotry and bullying – whether it’s in speech, or writing, or executive order – should not be tolerated.  The argument “I want to oppress you, and you don’t want to be oppressed. See we both have valid, differing opinions and we need to respect each other’s opinions” is bullshit.  “I like cherry ice cream and you don’t” are two valid differing opinions.  “I think that my rights to life, liberty, the pursuit of happiness, and basic human respect are inalienable, but yours are debatable ” is just straight up oppression.

There is no way to have a civil debate about whether or not a group of people should be eradicated. There is no way to have a civil debate about whether we have the right to exist.  Nobody has the right to require fat people to debate them for our lives.

Key to this situation is that the author not only didn’t learn from it, or even attempt to offer an apology. Rather, “Asked to comment on his release, Linda e-mailed that he didn’t understand what the dispute was about.”

For their part, the paper did understand what it was about, and they released a statement to prove it:

Bullying others is not OK. Body shaming is not OK. Racist views are not OK. Homophobia is not OK. The list goes on, but you get the picture. Let’s debate the issues, not make personal attacks on people.

The Daily Journal is more than a newspaper. We are people — people who care about this community and we come in all shapes and sizes. Not one person here at the Daily Journal likes or agrees with body shaming. Ever.

It’s unfortunate that the paper published this in the first place (according to their statement the editor was out sick and the staff published it because it was a regular column, and they’ve taken steps to avoid this in the future) but I appreciate that they saw their mistake and took appropriate steps.

If you enjoy this blog, consider becoming a member or making a contribution.

Like this blog?  Here’s more cool stuff:

Become a Member! For ten bucks a month you can support fat activism and get deals from size positive businesses as a thank you.  Click here for details

Book and Dance Class Sale!  I’m on a journey to complete an IRONMAN triathlon, and I’m having a sale on all my books, DVDs, and digital downloads to help pay for it. You get books and dance classes, I get spandex clothes and bike parts. Everybody wins! If you want, you can check it out here!

Book Me!  I’d love to speak to your organization. You can get more information here or just e-mail me at ragen at danceswithfat dot org!



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Tuesday, 21 February 2017

Life Update part eleventy two

Hello friends! Not dead, just busy. Lots of fun things have been happening around here lately so let me get you up to speed:

  • Gabe has been working hard all month on a YUGE elections campaign project for school. He hands it in today and I'm SO NERVOUS. He's put a good effort into it, with a lot of guidance and prodding from Ryan and I, so if he gets a bad mark we're all going to be devastated. But, if nothing else, it's given us an important insight into how Gabe's brain works, and doesn't. He has such a hard time with getting his ideas out of his head onto paper in full sentences and paragraphs. He does much better with lists. Technically he's met all the requirements of the project so he wont fail, but I just have no idea how well or how bad he'll do.
  • We spent the long Family Day weekend in the Soo visiting family and we had a BLAST. Saturday was spent with my side of the family at my mom's. We went sledding, had a massive snowball fight, built forts in the backyard for another snowball fight and topped off the day with a delicious spaghetti dinner. The next day we went for a swim in the afternoon with my mom, inlaws, sister in law, her kids and mine, and I was able to enjoy an outdoor hot tub for the first time. Dinner was at Casey's then home to relax. Monday was the Bushplane Museum and despite a half hour wait to get in the door because Family Day, we had a good time. We drove home Sunday night and sang along to our family road trip song, We Will Rock you/We Are the Champions.
  • Earlier this month I cemented a friendship with a lady I know a couple of different ways; during a snow day Erin came by to pick up the kids and I and bring us to the indoor play place. Unfortunately I hadn't shoveled the driveway and her mini-van got stuck. No amount of pushing was helping and even after we shoveled out a bunch of snow we needed rescue from a couple of Eastlink guys who happened to come by. Despite her almost running me over (putting the car in park before you get out is important!) I think our friendship was cemented with all the laughs.
  • Still waiting to get things resolved with National Student Loans. Still waiting for Ryan's paperwork to be finished with the Ministry of Transportation so he can get his special license for work.


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Monday, 20 February 2017

You Are Not Subtle With Your Hate

Inspired my my dear friend Ali over at Mean Fat Girl, I want to expand upon her post That Thing Thin People Do.  The thing is, we see you, thin people.  You think you’re being OH SO SUBTLE in your little judgements and smirks and insincerity towards us, but there’s one thing I can promise you – you’re not subtle.  You’re not even original.  Because when I sit down and talk to other fat people, particularly fat women, I hear the same things over, and over, and over again.  So perhaps if I lay them out in a nice, easy to read list, you can all see just how blatantly obvious you are with your cruddy behaviour, and maybe you’ll understand why so many of us simply don’t trust you, or even like you.

Oh you might not do all of these things, nobody is saying that.  But I’m quite sure you do some of them, because I and other fat people have seen you do it.  Time and time and time again.  And if you are one of the few who DON’T do these things, then this is not about you.   Don’t get all “not all thin people” at me – it’s no different to #NotAllMen or #NotAllWhitePeople

Things Thin People Do

  • Expect their fat friends to hang out with them for hours on end while they try on clothes that are not available to them, without ever returning the favour, or being cognizant of how fat people are excluded from clothing
  • Scowl at fat people in public
  • Laugh at the idea of fat people dating, being in love, having sex.
  • Laugh at fat people in public
  • Assume that fat people are all lazy gluttons
  • Decide how much and what fat people should eat.  Those “Are you sure you want that?” comments.
  • Nudge their partners, friends, family and point out fat people in public
  • Take photographs of fat people on their mobile phones
  • Talk about our bodies to other thin people, particularly about whether you think we are lazy or gluttonous.
  • Say things like “If I ever get like that, kill me.” In reference to our bodies
  • Inspect our shopping carts and baskets
  • Watch us eating, staring, following every morsel of food from our plate to our mouths.
  • “Compliment” us only when we wear dark colours, or clothes that hide our bodies, but if we wear anything colourful or that shows skin, you’re suddenly silent.
  • Talk about how fat you are, in front of us, like being fat is the worst, most disgusting thing you could be.
  • Use us to make yourself feel better about yourself – “at least I’m hotter/better/thinner than her.”
  • Speak to us as if you’re our intellectual superiors.
  • Assume we’re exaggerating or over-sensitive when we talk about how rude and hurtful people are to us.
  • Talk over us about fatness, bodies and eating disorders, as if you have more expertise on our bodies than we do.
  • Tell your children “You wouldn’t want to get fat now.” Right in our hearing, again, as though that’s the worst thing that a human being could be.
  • Laugh when your children parrot the hateful things to us that you have taught them.  As if saying something mean to a fat people is funny or cute.
  • Do absolutely nothing when someone says something hurtful or hateful about fat people in front of you.

And most tellingly;

  •  Get offended when fat people point out the many ways that you behave rudely or hurtfully towards us.
  • Make excuses for all of the above.

That’s right.  Ask yourself right now – has the list above pissed you off, or offended you?  If the answer is yes, then I’m talking about you.  If you’re bothered that I and others are pointing out all of these appalling behaviours, then perhaps ask yourself why you’re so invested in being “allowed” to treat fat people with such disrespect and hate.  What kind of person are you that you think any of the above behaviours are acceptable towards another human being?  Would you accept people behaving like that towards you?  Would you respect, trust or want to be around people who exhibited those behaviours towards you?

As I said at the beginning of this piece – fat people see you doing this stuff.  It’s not subtle at all, you’re not sneakily engaging in something that nobody will notice.  We see you.  And instead of internalising your disrespect and hatred of us, we’re learning to shine a spotlight on it for what it is.  That might make you feel uncomfortable, or ashamed.  Good – that’s how you’ve been making us feel about our own bodies for so long.  The difference is, our bodies are not harming you, they are just that – OUR bodies.  None of your business.


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