Just Too Funny

Many thanks to Theresa Baker, The Fat Personal Trainer, for linking to this hysterical comic strip.

Click here.

And BTW, I love the subtitle for Theresa's blog: Health at YOUR size.

And I love her motto:
You can starve a Saint Bernard, but you ain’t gonna turn it into a Greyhound.

Now that's my kind of gal!

"Paleo Physical Activity"?

Image source: Arizona Caveman


Just bear with me. I'll get to the point...

A number of people swear by some version of the "paleo" diet. I'm not hugely familiar with the ins and outs of this diet, but the general idea (as I understand it), is to eat the way our ancestors did: lots of lean meats and fish, little to no grains ("Wheatbelly") or dairy and certainly no processed, sugary foods. The premise is that our bodies have basically not evolved much since paleolithic times and have not adapted to "modern" foods. We thus have trouble digesting such food groups as dairy, wheat and sugar and should therefore avoid these food groups to the best of our ability to maintain optimal health and weight.

This post has nothing to do with coming down either for or against the paleo diet. Instead, I would like to look at taking the principle that we should "eat like cavemen" and ask ourselves whether it is even more important to "move like cavemen".

A spate of recent and not so recent posts by weight loss warriors has got me wondering. So many people (especially women), who have made huge (some might say, superhuman) efforts to lose weight now find themselves increasingly deprived of one of their strongest weapons in the fight to keep the pounds off: exercise.

Their bodies--in particular their knees--have made it clear that "enough is enough". They are forced to cut back on running, Zumba, squats, lunges--all the heart-pounding exercises that enable them to maintain weight loss without starving...because, as it becomes horrifyingly clear to the tiny minority that actually gets the "excess" weight off, they cannot eat like "normal" people. The number of calories needed to maintain a reduced weight is usually much lower than the number of calories that someone who has never dieted can eat to maintain that same weight.

Why are our knees (and sometimes our backs and sometimes our hips...) so incredibly unhappy after a few short months or years of modern exercise? I would posit this has less to do with the excess weight that we may or may not have carried and a lot more to do with exercise for weight loss maintenance.

Common sense tells me that our ancestors were not lacing up their runners to pound the pavement X hours per week. Yes, they were running. But they were running because they had to: to catch prey to eat (these are the men running, mostly), to escape from animals trying to eat them (everyone running) and to catch little paleo people about to jump into the rapids and be carried off to their death (mostly women doing that kind of running). Nor were our paleo ancestors running on pavement. They were running barefoot on hard earth, grassy plains, sand (every tried to run on sand? it's tough). They certainly didn't have a training schedule.

What else were our ancestors doing? Squatting. Not "squats" as in exercise, just sitting around squatting, waiting for tasty animals to wander by or squatting as they picked food out of the ground or picked lice out of each others' hair.

[Fun digression, now: I often wonder whether reincarnation has any truth to it. I have a friend who has a PhD. in Latin American studies. Her research deals with Guatemala at the time of the Spanish conquest. One of her parents was from England and the other was born in Canada, though they were both of eastern European origin. There is not a drop of native Guatemalan blood running in her veins. Yet, for as long as I've known her, long before she went to Guatemala for the first time, she has been a squatter. In fact, she reminds me very much of what I imagine a Guatemalan Indian woman would look like, squatting by the fire cooking a meal for her family.]

Squatting is great for keeping the hips flexible. Probably the worst thing that ever happened to our hips was the invention of the chair. Sitting in chairs has robbed us of so much natural flexibility, which is especially important for women in childbirth. Hmm, ever wonder why the rate of C-sections is so high in the Western world (and I say this as someone who has had 2 C-sections and would have no doubt died the first time around had this surgical intervention not existed)?

Oh, and perhaps the most important thing our ancestors were doing on a regular basis was walking. They probably didn't take any strolls but I'm sure they walked up a storm. They were busy just trying to stay alive. And that involved sometimes walking very long distances. Back in paleo times, they didn't have the wheel, never mind cars to get them to the mall (what mall?)! They walked.

What's a person to do in our modern world?

Honestly, I don't have a magic solution that will work for everyone. What I do know is what I see: people will go to great lengths and often dangerous lengths to take and/or keep the weight off. Not to make the body healthy, just to fight against a higher weight.

There's so much more to health than burning calories and there's so much more to physical activity than pounding the pavement and pounding your knees. Your knees may accept the pounding, but many knees will not. Paleo physical activity, anyone?

A Picture is Worth a Thousand Words

A friend posted an amazing picture on Facebook.

Although I was able to cut and paste it here, Blogger would not let me publish my post. Too big. So, here it is, in words.

The photo shows a scale, with the following hand-written words written on the place where you stand:

The number on this scale will not tell you:

• What a great person you are
• How much your friends and family love you
• That you are kind, smart and funny in ways numbers cannot define
• That you have the power to choose happiness
• Your own self worth

And I would add: "your actual state of health".

*I* Did Not Say *That*

So, in the on-going debate that unfortunately pits people of good will against each other, the greatest enemy, the deux ex-machina that gleefully causes us to raise our hackles against each other, is the righteous indignation that Internet-mediated discussions seem to constantly spawn. In other words:

I (most certainly and emphatically) did not say that. I have been misquoted and my words twisted in ways that defy all intelligence into ideas that I never expressed.

In my last post, I seem to have both provoked this reaction and felt it myself.

I won't go into the provocation side of the equation. To do so would mean picking apart the post that led me to riff on a concept near and dear to my heart, Health at Every Size. And that would no doubt lead to more recriminations, followed by more righteous indignation over my seemingly intentional misinterpretation of someone's thoughtfully expressed words. I don't want to go there.

Sadly, in great part due to the way discussion is obliged to take place on the Internet, honest disagreement is easily viewed as trashing, insulting, or ugly "dissing" behaviour. Most of the time, I therefore find myself refraining from responding to posts I disagree with. An exchange of ideas can quickly turn into, or be perceived to be, an attack, even if that was the farthest thing from the writer's mind when expressing the initial disagreement.

There seems to be little room for disagreement and the comments section of most blogs looks either like a mutual admiration society or degenerates into mud-slinging, hurt feelings or any number of ugly reactions.

Now, on to my potentially feeling the sting of being misinterpreted myself.

I have written a number of posts on Health at Every Size. I insist on spelling out expression rather than using the acronym, HAES, because it seems that whatever I say, somehow the word "health" disappears and I am left with questions like this one, asked by reader Norma in response to my most recent post on HAES:

I am asking this question out of honest curiosity about the HAES belief system and not with snark or sarcasm, so I would appreciate an honest and polite answer. Does the concept of "health at any size" apply to ANY size or only oversized? i.e., do its followers feel that, for example, an 85 lb. anorexic adult woman can be healthy? Again, I am asking this question sincerely only because the only take on the subject of HAES is without except about and by larger people. Thank you.

I didn't have the opportunity to answer the question yesterday for a variety of reasons, so I'll try to respond now, despite the fact that an anonymous reader has already stepped into the fray and given an excellent response too.

First, thank you Norma for framing your question as one not posed out of snark or sarcasm, but rather because you'd really appreciate an honest answer.

Here's my response:

How could I consider an 85-pound anorexic healthy? She is doing everything in her power to kill herself. Anorexia is a lethal disease, and a quick acting one at that. Why, please, please tell me, would I ever consider anorexic behaviour to be healthy? I just don't get it. It's called intentional starvation. Last time I looked, starvation was not considered a healthy way of living.

By the same token, just because I have observed that dieting is often a collection of disordered behaviours (and interestingly enough, the kind of behaviour that gets an anorexic put in hospital is often praised and encouraged by health care professionals when it's an overweight person acting in a similar way); that dieting often leads to further weight gain; and that the diet culture negates the fact that nature is full of size diversity...

[BIG, BIG note to readers: I DID NOT JUST SAY that ALL dieters engage in dangerous, disordered eating behaviours NOR DID I SAY that ALL dieters will eventually eat their way up the scale. I simply said that these phenomena have been observed and I will add that they're not at all that uncommon, in my opinion.]...OK, let's take a deep breath and I'll finish this long sentence...

Despite [the long introduction that you've just read], I have never, ever said that eating yourself silly is any healthier than being an anorexic. Neither the 85-pound anorexic who is starving herself of both vital nutrients and vital calories nor the whatever hundred pound person eating compulsively and constantly are healthy and they are definitely not engaging in healthy behaviours.

The reason I support "health at every size" is because there is a growing body of evidence which shows that simplistically equating body size with good or bad health is downright wrong. People can have health problems when they are slim, medium sized and large. People can also be healthy at a variety of sizes. Yes, certain health problems are correlated with being overweight (and indeed some with being underweight), but that does not mean that the number on the scale can be used as a kind of shorthand to express one's health status.

The work of Dr. Steven Blair (and others) has demonstrated very convincingly that moderate, daily exercise is a much better indicator of health than is one's weight. However, as long as one stays firmly with the weight loss = good health paradigm, and since it is so exquisitely difficult to maintain a significantly weight reduced body, many people have a tendency to give up and not only eat themselves back up the scale, but give up on doable things to help improve their health like moderate, daily exercise, good nutrition and improving one's mental health.

As I've said time and time again, exercise and good nutrition are key. Going from a totally sedentary life to walking 30 minutes a day and making sensible changes to the food one eats (I personally am not in favour of a diet based on junk food, no matter how tightly calorie-controlled it is--but that's just my opinion) can lead to weight loss. But maybe not. Such changes will definitely improve one's health, though.

I know, but what about the knees, the blood sugar, the blood pressure? First, there's correlation vs. causation. If being overweight directly caused these health problems, then they would only be seen amongst the overweight and never amongst the "normal" weight. This, of course, is not the case. One of Dr. Blair's findings shows that overweight people who engage in regular physical activity are not statistically sicker than normal weight people and certainly healthier than people of high, normal or low weight who do not participate in any physical activity.

But you've got a right to ask again "what about the knees, the blood sugar, the blood pressure?" If your weight loss has improved these markers and you can maintain this loss despite the fact that it will become increasingly difficult as you age, "kola kavod" (more power to you, in Hebrew). However, your road to better health (and I mean better health, not simply a lower number on the scale) just does not work in a reliable, sustainable manner for the vast majority of people.

But even more importantly, weight loss is not the only road to health. It's simply the only acceptable road to so-called health that exists in this society, at this time in history.

Long answer.

Once Again, With Feeling

I admit it: I read a few dieting blogs. Here is my response to a post I read today on Screaming Fat Girl, a blogger for whom I have a lot of respect though our world views and attitude towards dieting differ somewhat.

I'm sorry SFG, but I really can't agree with you, nor can I condone your lumping all those who condemn the dieting culture into the "sore losers" (pardon the pun) category.

First, there is ample (again, pardon the pun) proof that for the vast majority of people, dieting does not work. If dieting were actually a statistically valid option, the weight loss industry would not be pulling in a staggering $60 billion per year. We are pouring every cent we have into books, classes, meal replacements, packaged meals, etc. in order to lose weight and where has it gotten us? Fatter and fatter.

The science behind why we weigh what we weight is hugely complicated. The number of physiological factors governing our ability to maintain, lose or gain weight is staggering. Leptin, leptin resistance, ghrelin, insulin, insulin resistance and a whole host of other chemicals and chemical reactions in our bodies come into play. I strongly recommend reading the blog "Debra's Just Maintaining" from start to finish for a clear-eyed, intelligent and scrupulously honest look at the life of someone who is both a weight loss maintainer and a "lay-analyst” par excellence of the science behind the difficulties of weight loss maintenance.

I do not claim to speak for the fat acceptance world. I consider myself a proponent of Health at Every Size and in the HAES world, what I see is quite the contrary of giving up. I see people working really hard to improve their health in so many ways. The one thing they are not doing is adopting the overly simplistic, dare I say jingoistic approach of "calories in - calories out", which even bariatric experts like Dr. Arya Sharma have condemned (he calls it the Nightmare on ELMM Street).

There is so much we can do for our health that is not dieting. For many people, it starts with what is in our heads. I have noticed that a significant number of weight loss bloggers admit to having experienced severe physical and/or emotional trauma during their formative years. Rape victims, for instance, often eat huge quantities of food in a vain attempt to build a protective wall around themselves. They end up with extremely fat bodies though their fear remains unassuaged. Emotional eating or emotional food restriction cannot be adequately dealt with and overcome through a strict diet regimen (for the overweight) or by simply forcing food down the throat of an anorexic. The psychological factors must be dealt with. Simply manipulating one's food intake is, in the vast majority of cases, not enough to effect lasting change.

I am convinced that the so-called obesity epidemic is the result of factors like, but not limited to:

-severe trauma amongst a certain segment of the overweight population;

-an abundance of scientifically engineered foods that are hyper-palatable, energy-rich and nutrient poor and often much cheaper than unprocessed or minimally processed, whole foods;

-the car culture, especially in North America;

-a culture that defines the individual as either super-fit or beyond redemption, thus making it psychological torture for an overweight person to even show their face in the gym;

-a culture of divide and conquer: the 99% vs. the 1% (but that's a whole other kettle of fish);

-and finally, the inability to accept that people come in a variety of shapes and sizes (both vertical and horizontal), which leads many people who were born with a genetic predisposition to plumpness (and that absolutely exists) to take drastic means to reduce their weight, which in turn often leads to yo-yo dieting one's way up the scale. How many people, in particular women, look back on pictures of themselves when they first started dieting and realize with horror that their repeated attempts to "fix" a perfectly fine body have led them into morbid obesity?

Learning to eat mindfully rather than ravenously gulping down all the food in sight because “tomorrow”—once you go on a diet—you will be forevermore condemned to a life of privation and lots of lettuce without any dressing, ever, ever, ever; and learning to make physical activity a regular part of your life rather than a torture that one must undergo to flatten the belly and tone the arms are absolutely NOT the signs of someone who has given up. They are the signs of someone who is working with her heart and soul to be healthier in body and in mind.

I have no doubt that many (though not all) people might lose some weight if they decide to learn to eat mindfully (and this is not learnt overnight, nor is it easy) and to make physical activity an integral part of their everyday lives, even if it simply means walking rather than using the car when at all possible. But will they all become slim? There’s a pretty fat chance of that (this will be my last “pardon the expression”).

We will eradicate the 25+ BMI body the day we eradicate natural body diversity, the day we can ensure that all women will be at least 5’2” in their stockinged feet and have a pleasantly generous, though not excessively large bust; the day that all men have a penis measuring X inches long and biceps that are at least X inches around (I have no idea of the “normal” measurements for either of these examples); and the day that no one is ever born with anything but blue eyes and blond hair.

To paraphrase John Lennon, “give health (rather than the futile quest for the so-called perfect body) a chance”. This, to me, is far from giving up.