Pat Hartman | Childhood Obesity News

Multifactorialism Makes Zipping Up a Slow Job

Pat Hartman June 4, 2019 2 Comments

This post finalizes the summary of posts about the intersection of overuse with tobacco, alcohol, and food. One area not covered yet is the presence of pharmacological intervention in tobacco, alcohol, and food limitation, so we have that to look forward to.

“Rubber, Meet Road“ is in itself a roundup of several interesting points, and “Road, Meet Rubber“ is another. “The Rubber-Meets-Road Test“ is also a compendium. In this area of knowledge, which Dr. Pretlow calls both tricky and muddy, there are many strands to follow, and, of course, new information is being generated all the time.

“Road and Rubber Continue to Meet”

What happens when standards, ideals, aspirations, principles, and values collide with reality? Authorities confer with experts and each other, and then try various methods to make things better. A hard-won victory was the limitation of cigarette brands appearing in movies, but it is unlikely that the same result could be gained with the depiction of food in the audiovisual media.

Sometimes there are hopeful but limited results. Far too often, people continue to smoke, drink, and overeat. Some people remain obese, while others become obese, and still others devote themselves to achieving recovery from what they have learned to identify as food addiction.

Barking up the wrong tree?

If food is addictive, it makes sense to limit the availability of addictive foods. That is easier to do with children than with adults. Another desideratum is the avoidance of glorification of problem foods, through the media. Public communication has entered a surreal category beyond parody. On the same magazine cover, women are enticed by the food-porny photo of “A cake to die for” and offered redemption through “a diet to live for.”

If compulsive overeating is a behavioral addiction, what advertising might be banned to try and correct the situation? And is the marketing department the only villain? A large proportion of obesity apparently comes from a different place, from an individual’s perception of emptiness and deprivation. It is a truism that many overeaters use food as a substitute for love. Often, what a person really wants is connection. Therapy can train a person for connection. More psychologists and psychiatrists need to be in the obesity prevention field.

Therapy can also help a person figure out how to resist the false connection offered by consumerism. Ads sell the illusion of belonging, and of superiority through being part of a faux-culture composed of people who smoke the same brand of cigarette or drink the same brand of sugar-sweetened beverage.

When people derive a large part of their identity from their loyalty to corporate overlords, this is extreme codependency. It is hard to imagine them getting better through any means short of extensive, intensive therapy. But would it be possible to ban a certain sub-genre of advertising, the kind that encourages the customer’s identity to be subsumed by the product?

Your responses and feedback are welcome!

Photo credit: Luca Florio on Visualhunt/CC BY-SA

Zipping Toward the Finish Line

Pat Hartman June 3, 2019 1 Comment

This zipper-themed series summarizes all the posts that tie together food, alcohol, and tobacco, to see what can be learned from attempts to limit alcohol and tobacco addiction, and apply that experience to curbing food overconsumption, and thus obesity.

“The Exercise of Well-Intentioned Control”

As we observed here, every attempt to scrutinize some corner of this enormous issue seems to generate more questions, and to reduce the number of what might have previously been welcomed as answers. In comparing the efforts to cut down on tobacco and alcohol abuse, and food abuse that leads to obesity and numerous co-morbidities, examples refuse to align precisely. Exact parallels are thin on the ground.

Nevertheless, there are enough similarities to cause trouble. When it comes to the question of attempted control through taxation, any anti-obesity activism in that direction is hindered by the extensive experience that Big Alcohol and Big Tobacco have already accumulated. To resist governmental interference, they have spent millions on clever lawyers and compiled a playbook from which Big Food can benefit.

“Where the Good-Intentions Rubber Meets the Reality Road”

We looked at government public relations announcements related to the 2012 anti-smoking campaign, and quibbled with the language that implied hundreds of thousands of smoking cessation successes on very little evidence. This is helpful to no one.

“More Rubber Meets the Road”

We also looked, not for the first time, at the public service announcement’s evil twin, advertising. Dr. Pretlow, along with many other health professionals and millions of parents, would be well pleased if all food advertising directed at children were to disappear. The industry is unlikely to make this happen voluntarily, so some type of government action would be required, and the battle would be ferocious and expensive.

The natural impulse is to look at what worked against smoking, and adapt it to obesity. We tend to forget what it took to get rid of some, and not even all, cigarette advertising — a long, grueling, costly battle.

When the government spends money trying to do something good, the people pay for the cost of that effort through taxation. When the industry spends money trying to do something bad, the people pay for the cost of these corporate efforts through price increases.

While nothing good can be said for a nicotine habit, food is necessary for life, and only some people develop health problems because of it. Seen through that lens, the worst food is more virtuous than the best tobacco.

Even though it suffers from the considerable disadvantage of occupying the moral low ground, Big Tobacco is a formidable opponent, and it has taught the food industry well. Sadly, any attempt to control that group of world-straddling corporations in any meaningful way appears doomed to encounter infinite resistance.

Like a trash-talking professional fighter, Big Food is perfectly positioned to say, “You don’t know anybody, that knows anybody, that knows anybody, that can knock me down.”

Your responses and feedback are welcome!

Photo credit: Maria Rantanen (Idhren) on Visualhunt/CC BY-SA

Zipping Onward

Pat Hartman May 31, 2019 No Comments

This series of “zipping” posts summarizes all the articles that explore the intersections between alcohol, tobacco, food, and threats to the public good. The other purpose is to elaborate on some ideas. “More About Mechanical Enablers,” for example, takes a deeper look at one piece of the healthful-eating puzzle that had been mentioned briefly in those archives.

“Fortunes Up for Grabs” looks at the sad fact that raising taxes mainly enriches shareholders. There is for instance the coat-tail strategy. When the cigarette tax goes up, knowing that the mathematically inept public expects to pay more, the corporations tuck a few extra percentage points into the profit column. When food is “sin taxed,” any hanky-panky that goes on in other “sin taxable” businesses can be expected to show up in the food industry. That seems to be the reality we are faced with.

“Soft Control” explores the role of vilification and ridicule in changing people’s bad habits, including the fact that blaming and shaming can backfire spectacularly.

“More Soft Control” mentions the American Medical Association’s concern about stigmatizing “low-income and other vulnerable populations of smokers,” because people who already experience disempowerment tend to feel defensive and resentful when preached to by others who have not walked a mile in their shoes. Well-intentioned attempts to help can be perceived as patronizing and condescending, and very little good is accomplished.

The AMA Journal of Ethics said,

[I]t would seem important for public health campaigns to target all tobacco users, not just ethnic minorities and tobacco users of low socioeconomic status.

Any government action needs to be carefully considered from many angles. Consultation is needed with genuine experts, not political appointees and corporate shills. The path forward is booby-trapped with unintended consequences. As much as people dislike interference with their smoking and drinking habits, they really take umbrage when their eating habits are criticized.

In many cases, centuries of tradition are involved in the matter. In most cases, nobody wants a recommendation to eat a piece of fruit from the health food store that costs their entire monthly SNAP allowance.

Your responses and feedback are welcome!

Source: “Decreasing Smoking but Increasing Stigma? Anti-tobacco Campaigns, Public Health, and Cancer Care,” AMA-Assn.org, May 2017
Photo credit: Andrew Magill on Visualhunt/CC BY

Zipping Through More Comparisons

Pat Hartman May 30, 2019 No Comments

Professionals concerned with obesity prevention are very interested in what methods might be induced to carry over from smoking cessation programs and alcohol interventions. This page continues to gather some of the main points from recent posts.

“More Parallels in the Quest for Control”

In the realm of food overconsumption, 12-step programs like Overeaters Anonymous have a respectable word-of-mouth reputation, although scientific verification is elusive. Bariatric surgery is unique to the food area, there being no equivalent surgical procedures to prevent the consumption of alcohol or nicotine.

Geographic limitations, like forbidding food and drink in pedestrian malls, parks, and other public areas, would probably never fly. Even if such a rule were enforced, the largest benefit would accrue to neatness and a lack of litter, while the overall effect on obesity would be difficult to validate.

“Can Tobacco Suppression Be a Model?”

And yet, some locational prohibitions have been outstandingly successful. We no longer smoke in hospitals; cigarette butts no longer litter the floors of college classrooms; and landlords have decreed that tenants have no right to smoke in the apartments they pay to live in.

In 2009, the Family Smoking Prevention and Tobacco Control Act limited the powers of the Food and Drug Administration in several ways. The law cannot require prescriptions to purchase tobacco products, or require that the nicotine content be reduced to zero, or ban certain classes of tobacco products, or “ban face-to-face sales in a particular category of retail outlets” — which sounds minor but which the industry must have fought hard against. If attempts are made to impact obesity with similar legislation, we must expect the same kinds of objections and exceptions.

“The Big Three — More Similarities and Differences” goes into the nuances of why and how public smoking and alcohol drinking are different from public eating (and drinking of any other beverage). “The Coulds and Shoulds of Control” examines a particular case, the all-you-can-eat style of restaurant, with the arguments for and against it.

“Suing the Devil”

This post looks at the strange contradiction in how different branches of the government are pitted against each other, on one hand encouraging and subsidizing the suppliers of tobacco, while on the other, taxing and scolding the consumers of that very product. We also observe the hanky-panky involved when corporations compensate the states for letting them do business. Obviously, lessons need to be learned before the government contemplates taking further control of food.

“Taxing the Devil”

And this post examines the strange phenomenon of the “sin tax” that piles extra penalties on such oddball enterprises as tanning salons. The tax on liquor is supposed to help pay for the damage caused by alcohol-related vehicle accidents. But how might the public be convinced to ignore the qualitative difference between the horror of dismembered bodies, and the relatively unspectacular damage caused by food-related obesity?

Your responses and feedback are welcome!

Source: “Family Smoking Prevention and Tobacco Control Act — An Overview,” FDA.gov
Photo credit: Clare Black on Visualhunt/CC BY

More About Mechanical Enablers

Pat Hartman May 29, 2019 No Comments

Being capable of delivering junk food, fizzy drinks, cigarettes, and even alcoholic beverages, vending machines are capital-T trouble. Academic research teams often receive credit for self-evident facts, but their purpose is, after all, to verify hypotheses. Journalist Daniel Westlake wrote,

According to a study by the University of Michigan and Michigan State University, vending machines stocked with unhealthy options for young people often help lead to unhealthy eating habits.

Vending machines are a notoriously problematic means of distribution, with drawbacks like mechanical issues, quality and condition of the products, and of course cleanliness. Question for the reader: When is the last time you witnessed someone cleaning the inside or outside of a vending machine? We thought as much.

Customers have actually gotten sick. Westlake adds,

Sometimes food in these machines can melt, spill or go bad, in the machine which can draw insects and rodents to the machine… Every few weeks, open up the machine and clean it so that there are no bits or food or dust which may have accumulated on the products… Clean the tray where the snacks or items fall, as this is the area where most of the food refuse may be located if their packaging breaks. Clean the buttons since many people’s fingers are probably dirty.

(But what about the cleaning solution being sprayed into the closed environment occupied by food that people will in all likelihood not wash before eating? Just asking.)

There could be other obstacles to popularity. Not everyone enjoys cold fruit. Many kinds of fruit are much more tasty at room temperature. Not everyone has the teeth to deal with anything more resilient than a banana or a melon cube.

What happens to fresh produce in this setting? The enormous waste ratio was a recognized drawback in 2010, and likely still is. In that year a major vending machine manufacturer teamed up with a major fruit corporation to tackle the problems. A two-minute video produced by the company explains temperature variation, the food elevator, and other features of their machine.

In the following year, as a random example, one company publicized its 400 fresh-fruit vending machines in 25 states. Gil Sanchez, owner of Vend Natural, described his philosophy to a reporter, who wrote,

Vending machines are part of the solution for childhood obesity, he said. About 96% of his machines are in schools.

A piece at Organics.org describes next-level vending machines in Scotland that are a combination snack bar and farmers market, along with some other technological marvels. No more will be said about that article here because it really deserves to be absorbed in all its profusion of detail.

These are the rather extravagant claims made by a rival company whose vending machines dispense canned fruit:

Fresh fruits are likely to lose nutrients when they are exposed to air. This doesn’t happen with canned fruits… A lot of people buy canned fruits from vending machines for its “liquid” […] All canned fruits are packed with plenty of liquid syrup. The syrup has extra sugar and calories… Nutrients from this liquid syrup will keep you revitalized and energetic… Economically, canned fruits are several times cheaper than fresh fruits too.

Your responses and feedback are welcome!

Source: “Problems with Vending Machines,” BizFluent.com, 09/26/17
Source: “The Great Banana Challenge,” WSJ.com, 10/21/10
Source: “Vending machines offer major growth for fruit, vegetables,” ThePacker.com, 05/17/11
Source: “These Vending Machines Serve Fresh Veggies Instead of Junk Food,” Organics.org, 05/07/19
Source: “What? Fruit in a Vending Machine?,” ImperialCo.com, 02/27/16
Photo credit: Jonathan Lidbeck on Visualhunt/CC BY

Zipping Through the Comparisons Between Tobacco and Food

Pat Hartman May 28, 2019 No Comments

An interesting study highlighted the complex relationships between the circumstances involved in smoking. Yes, our old friend multifactorialism shows up here, as in so many places. The authors looked at a particularly troublesome area, “occasional smoking.” The wrote,

Factors such as social pressure, weight control, positive reinforcement and taste are the main motivators for smoking in this group, unlike the “daily smokers”, whose motives are related to current theoretical models for dependence, involving tolerance, craving, loss of control and withdrawal symptoms. Thus, two forms of behavior need to be studied separately in future studies.

The occasional smoker has a low degree of dependence on cigarettes, and yet a paradoxically high level of difficulty in quitting. But the current received wisdom is that people are hooked because of physical addiction. What explains this? The authors seem to say that people who don’t smoke very much may have a harder time quitting than the constant smokers, which is interesting, but not necessarily relevant to compulsive overeating.

The relevant part is that in obesity, the multifactorialism is much more obvious. When smoking is the problem, there are plenty of societal, emotional, and other facets to deal with, but only one substance, nicotine. But food is an enormous category of substances, all grown and processed and prepared and combined in so many ways, the variables involved in figuring it out are insane.

Here, we pick up from a previous post, “Zipping Through Anti-Obesity Possibilities,” in an overall attempt to learn whether anti-obesity efforts, especially those imposed by government orders, can borrow from smoking cessation efforts or programs designed to end alcohol addiction.

“Parallels in Tobacco, Alcohol, and Food Control”

Great Britain has tried, with small success, limiting sales promotions like “buy one, get one free.” It has tried encouraging manufacturers to include less sugar in soft drinks, with limited results. In the USA, anti-smoking activists have pushed the idea of putting less nicotine in each cigarette, which would probably lead to people buying even more cigarettes and enriching the tobacco moguls even more.

Prohibitionists were happy about 1998’s Master Settlement Agreement, which was supposed to encourage better behavior from the tobacco industry, but which mainly, in effect, bribed the states to allow pretty much the same behavior as always. Plus, consumer prices went through the roof. As disincentives go, price seems to be a weak one. If people want a thing, they will buy it, or steal it.

Just days ago, it was announced that the federal government wants to raise the legal smoking age to 21 in every state. Does anyone foresee any problems? Unlike heroin and cocaine, tobacco does not have to be smuggled into the country, so the expense involved with international transport and payoffs to officials and border guards would not even be a drawback.

An incredible amount of illegal money is just waiting to be made. Could this possibly lead to the greatest growth of criminal organizations since alcohol Prohibition? The vendors of this illegal product would not all be seasoned mobsters, either, but high school students selling to their peers. It might be quite a mess.

Then, imagine trying to follow it up with anti-obesity legislation based on age. Who would decide the appropriate age for purchasing soda pop or cupcakes? Who would be in charge of deciding which of the thousands upon thousands of separate and distinct consumer products would be age-limited? As much as everyone wants answers to the obesity epidemic, the age limit idea is probably a non-starter.

Your responses and feedback are welcome!

Source: “Tobacco smoking: From ‘glamour’ to ‘stigma’. A comprehensive review,” Wiley.com, 10/09/15
Source: “McConnell introduces bill making the legal smoking age 21,” RollCall.com, 05/20/19
Photo credit: independent designer on Visualhunt/CC BY-SA

Obesity Exploitation?

Pat Hartman May 24, 2019 1 Comment

This post is a continuation of the previous one, “Much Ado about Nothing?” and its predecessor, “Tempest in a Teapot?” For Reuters, Chris Kirkham and Lisa Girion reported on how, while Johnson & Johnson’s legal department was occupied defending itself against lawsuits about ovarian cancer, the customer demographic had changed.

With publicity about the danger of inhaling talc, mothers quit using baby powder for babies, and it got to where more than 90 percent of the product was bought for adult use. Powder is helpful to reduce the discomfort of perspiration in skin folds and fat rolls, especially where the temperature is high.

By the early ’90s, the company recognized two groups of loyal longtime customers: minority women and overweight women. Those constituencies include plenty of crossover, a convenient happenstance for the marketing department which worked diligently to boost sales to them. J&J took it to the next level and, following the example of fast food and soft drink manufacturers, adopted a racially targeted strategy.

Kirkham and Girion wrote,

The “right place” to focus, according to a 2006 internal J&J marketing presentation, was “under developed geographical areas with hot weather, and higher AA population,” the “AA” referring to African-Americans.

Reuters analyzed massive amounts of email correspondence and reams of internal marketing documents, along with advertising campaigns, to reveal the strenuous efforts the company has made to sell powder to overweight African-American and Hispanic women (or, as J&J calls them, “curvy Southern women.”)

The reporters mention,

[The company] advertised in Weight Watchers magazine and offered promotions through the Lane Bryant clothing chain for plus-size women and Curves, a women’s fitness and weight-loss franchise. Marketing plans also included ads to run […] during the Style Network show “Ruby,” a reality TV series that documented an obese Georgia woman on a mission to lose weight.

A 2009 presentation the the J&J top brass stated that “43% of our plan will focus on the top 10 overweight states in the nation.” The advertising department consulted with Weight Watchers about exactly how overweight the models in the powder ads should be. They lined up plenty of radio advertising, with contracts specifying that their ads would be broadcast only on hot days.

As always, the campaign was replete with contests, giveaways, coupons, discounts and samples. In the late 2000’s, J&J spent millions — and almost half of its powder promotion budget — on reaching out specifically to minority and overweight women.

The reporters also note:

Today, women who fall into those categories make up a large number of the 13,000 plaintiffs alleging that J&J’s Baby Powder and Shower to Shower […] caused their ovarian cancer or mesothelioma.

Is it unethical to target a segment of the public who are already insecure and defensive about their obesity? Is it wrong to appeal to large, perspiring women on the basis that the product will make them smell less offensive to others? Especially when the safety of the product is being contested in vicious courtroom battles? There have been large damage awards to customers in addition to the ones we have mentioned, and the corporation is currently appealing all of them.

Your responses and feedback are welcome!

Source: “As worries about Baby Powder’s safety mounted, J&J focused its pitches on minority, overweight women,” Reuters.com, 04/09/19
Photo on Visualhunt

Much Ado about Nothing?

Pat Hartman May 23, 2019 No Comments

Does baby powder, either with or without asbestos, cause ovarian cancer? Journalist Julie Steenhuysen says of Harvard epidemiologist Dr. Daniel Cramer that he…

[…] first reported on a potential link between talc and ovarian cancer in 1982. He has published several studies since, and his work suggests that talc exposure increases the risk of ovarian cancer, a rare disease, by 30 percent overall.

The previous Childhood Obesity News post left off with the realization that a randomized clinical trial, the gold standard of scientific proof, is impossible here, because we can’t just go around purposely injecting human subjects with suspected carcinogens. Steenhuysen also quotes Dr. Adetunji Toriola, of the Siteman Cancer Center in St. Louis:

We know that inflammation increases ovarian cancer risk. We know talcum powder causes inflammation. The question is, does talc cause cancer by causing inflammation in the ovaries?

The venerable Johnson & Johnson corporation was smacked down in a courtroom last year when sued by 22 plaintiffs who believed they developed ovarian cancer because, as adult women, they used baby powder inside their clothes to combat stickiness, discomfort, and odor. A jury awarded damages in an amount north of four billion (with a b) dollars. Of course, that decision is being appealed, as are similar ones. In January of this year, a jury found for a California woman to the tune of $29 million.

Meanwhile, one of J&J’s major talc suppliers has filed for bankruptcy. J&J is being investigated by both the Justice Department and the Securities and Exchange Commission, and a mind-boggling 13,000 additional lawsuits are on the docket. Actually, out-of-court settlements happen much more frequently than trials, are less costly to the corporation, and attract less publicity. But activists are restless and attorneys are hungry for blood and, apparently, juries have been feeling the same way.

Willful ignorance

Public outrage does not so much center around the possibility that the product might contain a dangerous component. After all, just about all products do, these days. We are accustomed to toxic everything. What gets people mad is the corporation’s decades-long awareness that the product might contain a dangerous component.

And how J&J played hide-and-seek with regulatory agencies. And how they introduced a new cornstarch-based baby powder, almost as if there was something wrong with the talc-based kind. And the company has a history of letting things slide. It was not until 2012 that J&J removed formaldehyde and another dicey chemical from their baby shampoo.

Coming up next: the Obesity Connection.

Your responses and feedback are welcome!

Source: “Evidence on Talc Cancer Risk Differs for Jurors, Researchers,” Reuters.com, 02/24/16
Source: “Does Johnson’s Baby Powder Cause Cancer?,” MedPageToday.com, 01/09/19
Source: “Johnson & Johnson Baby Powder at Issue as U.S. Subpoenas Company,” NYTimes.com, 02/21/19
Source: “Johnson & Johnson Challenges Ovarian Cancer Talcum Powder Verdicts,” KeaneLawLLC.com, 06/30/16
Photo credit (left to right): Mike Mozart (Jeepers Media) on Visualhunt/CC BY; Internet Archive Book Images on Visualhunt/No known copyright restrictions

Tempest in a Teapot?

Pat Hartman May 22, 2019 No Comments

Obesity exploitation, or much ado about nothing? What are we looking at here? The backstory stretches for many years. A recent Reuters piece starts out,

In 2006, an arm of the World Health Organization began classifying cosmetic talc such as Baby Powder as “possibly carcinogenic” when women used it as a genital antiperspirant and deodorant…

If ladies have been dusting the insides of their panties with a hazardous substance, that is one species of bad. But for decades, millions of babies have had their diapers lined with this stuff, multiple times per day, and because powder is easily airborne, they have also inhaled it. As far back as the 1980s, rumor and a few studies had depressed the sales of Johnson’s Baby Powder for actual babies.

According to the American Cancer Society, some talc contains asbestos, and asbestos is a known carcinogen when inhaled. Even without asbestos, nobody is sure what unadulterated talc does.

The job of the Cosmetic, Toiletry, and Fragrances Association (CTFA) is to self-police the industry so that the government will not feel obligated to do it. In the mid-1970s there must have been rumors of impending regulation to address these matters, because the CTFA issued…

[…] voluntary guidelines stating that all talc used in cosmetic products in the United States should be free from detectable amounts of asbestos according to their standards.

The wording is far from impressively severe. First of all, “voluntary” means, “if we feel like it.” Then, “should be free from.” Not “must” or “will.” And “detectable amounts of asbestos according to their standards.” This could mean anything. It could mean the company brings a drug-sniffing dog to the factory door, and if it doesn’t alert, they tell the CTFA that no asbestos was detected.

A 2013 study published in the European Journal of Cancer Prevention said:

The biological rationale for talc carcinogenicity has been misunderstood in terms of its chemical and physical properties, and other suggested mechanisms such as inflammation have not been supported by epidemiologic data. Talc is not fibrous and not genotoxic…

But three years later, Julie Steenhuysen reported for Reuters on the impossibility of proving conclusively that talc causes ovarian cancer, because of a procedural roadblock mentioned by Childhood Obesity News in connection with several different research projects. In scientific inquiry, certain acts are considered unethical, and deliberately exposing women to a suspected carcinogen is one of them. Aside from the fact that deliberately inducing a deadly disease would be wrong, it would be impractical, because sometimes cancer does not show up for years, and it would just take too long to get answers.

And we haven’t even come to the obesity connection yet. What a tease!

(To be continued…)

Your responses and feedback are welcome!

Source: “As worries about Baby Powder’s safety mounted, J&J focused its pitches on minority, overweight women,” Reuters.com, 04/09/19
Source: “Talcum Powder and Cancer,” Cancer.org
Source: “Perineal Talc Use and Ovarian Cancer: A Critical Review,” NIH.gov, 04/09/13
Source: “Evidence on Talc Cancer Risk Differs for Jurors, Researchers,” Reuters.com, 02/24/16
Photo credit: Access Ceramics on Visualhunt/CC BY-ND

Being Big

Pat Hartman May 21, 2019 No Comments

A very large portion of the health industry is devoted to helping people lose weight and stay at their new lower weight, a course that often turns out to be more difficult than the patient or health care personnel expected. Sometimes, a person realizes that she can only go so far and no farther. One possible choice is to accept it quietly. Another is to cross the fine line between fat acceptance and the militant advocacy of obesity.

Writer Selene Milano relates how she has lived through several cycles of making an effort to slim down, alternating with spells of just letting the whole matter slide. She reveals that a person might fall victim to a specialized bit of fatlogic that she compares to cleaning the house before the housekeeper arrives. In other words, at times the writer convinced herself that, before starting another weight-loss program, she would have to get in shape first. It’s a great way to stall for a few months, or forever.

Milano describes the shame spiral of being overweight, and also too embarrassed to do anything about it in a public place like a gym; and consequently gaining even more weight. She describes frustrating encounters with normal-weight people who want to be supportive allies, but somehow mess it up. One woman patted her like a pet doggie and said consolingly, “You’ll get there.”

Milano wants the world to know there is no “there,” or at least shouldn’t be. Instead, she has already arrived at a place where just showing up is worthy of applause, and getting into her workout clothes is another accomplishment, and participating in self-care is more than a journey, it is a destination where she is already at home.

Professional discourtesy

Of course, even with cool people, a new program or a new workout venue can inspire massive insecurity. Extreme self-consciousness makes it impossible to know if the oldtimers are actually emanating waves of judgment and pity, or if one’s own inferiority reflex is out of control.

At one point in the past, Milano enjoyed a period of harmonious progress with hot yoga, and years later decided to give it another go. During a part of the class when the participants are supposed to stand, she felt bad and had to sit down. Guess how the instructor handled that? Milano writes,

At the end of class in front of everyone he said, “If you’re not able to stand for even one full class you should really see a doctor.” Needless to say I was mortified and felt too ashamed to return.

Involvement with a popular but expensive workout regime resulted in the loss of some pounds, but Milano hated every minute of it. Discussing the conflict with her therapist, she was able to work through her feelings and arrive at a better place:

I stopped thinking about working out in terms of weight loss and more about self-care… Until recently, losing weight had always been my primary motivation for exercise, but my objective has shifted to trying to make peace with my body.

Ironically, exercise has helped me achieve that more than it ever helped me to lose weight. Feeling stronger and setting physical goals — and then crushing them — has given me a new found confidence and respect for myself.

Then, she found happiness in an indoor cycling class where “most of the talk is pushing yourself to make goals happen off the bike.” Sticking with this activity coincided with success in other parts of her life, and she does not mind assigning causation to the bike. Milano adds,

If you don’t love it, seek out an activity you do love. Find a place where you are supported and encouraged, and once you become a regular, pass that support onto someone else.

Your responses and feedback are welcome!

Source: “What It’s Really Like to Be a Plus-Size Woman at the Gym — and Why Losing Weight Isn’t My Goal,” Health.com, 04/10/18
Photo credit: CherryPoint on Visualhunt/CC BY

Multifactorialism Makes Zipping Up a Slow Job

“Road and Rubber Continue to Meet”

Barking up the wrong tree?

Zipping Toward the Finish Line

“The Exercise of Well-Intentioned Control”

“Where the Good-Intentions Rubber Meets the Reality Road”

“More Rubber Meets the Road”

Zipping Onward

Zipping Through More Comparisons

“More Parallels in the Quest for Control”

“Can Tobacco Suppression Be a Model?”

“Suing the Devil”

“Taxing the Devil”

More About Mechanical Enablers

Zipping Through the Comparisons Between Tobacco and Food

Obesity Exploitation?

Much Ado about Nothing?

Willful ignorance

Tempest in a Teapot?

Being Big

Professional discourtesy

Profiles: Kids Struggling with Weight

The Book

About Dr. Robert A. Pretlow

Presentations

Food & Health Resources