Beauty is kind of like health

The comments section of one of Ragen Chastain’s posts segued off into a criticism of any discussion of beauty.

beauty should not be a factor at all in movements like Fat/Size Acceptance. A woman should not have to identify as curvy, hot, sexy or beautiful to be accepted in Fat/Size Acceptance and this is what the movement is today

and

Still by stating that everyone is beautiful you are setting the grounds that being beautiful, a person’s looks are the most important thing about them. That the perception of beauty is the number one thing we need to change about the opponents of fat people.

Fat Acceptance spends most of the day on Facebook and Tumblr saying “you are beautiful” “Thanks and you are beautiful too”. That is not much better than the fat haters that say no fat person is beautiful or handsome.

Beauty is a outside issue that Fat Acceptance spends entirely too much time on, instead of dealing with Fat Issues.

First, I don’t know what Fat Acceptance sites the commenter is following where people sit around and tell each other they’re beautiful all day. If you look at the Fatosphere Feed right now, here’s what you’ll see:

• a post about depression
• a post about Star Wars filk
• Body Love Wellness’s yearly roundup post
• one post that talks about taking up space and being under constant public scrutiny
• one about the medical challenges fat, older women face during pregnancy
• an FA Christmas gift list
• my completely non-fat-related post about the Newtown massacre
• a post about the mixed messages given to fat people exercising

Take out the ones that aren’t specifically fat-related, and you’re left with 5 posts, only 2 of which have the slightest reference to beauty (the gift list and the Body Love Wellness roundup), and neither of which focus exclusively on it.

That doesn’t sound like an exclusive or overwhelming focus to me.

Yes, beauty is a thing that gets talked about in FA spaces. Sometimes in a warm, fuzzy “appreciate the beauty in everybody” way, other times criticizing the way women are judged so completely on their looks. I mean, I found “You don’t have to be pretty” through an FA blog. I don’t remember which one, possibly several.

I agree with some of the concern—that it’s easy to overvalue beauty and to buy into the idea that physical attractiveness is one of the primary goals people should strive for, especially if you’re a woman. We should recognize beauty as a nice thing but not a necessary one, and an optional one, not a duty.

But at the same time, freaking nowhere in FA do I see women “have to identify as curvy, hot, sexy, or beautiful” to be accepted. I think I recall, way back when, on Shapely Prose, some disagreement on someone calling herself ugly, because people have the same “oh my gosh, no you’re not!” reaction to “I’m ugly” that they do to “I’m fat.” And even in that discussion, I’m pretty sure it was widely accepted that beauty does not determine anybody’s value as a human being.

I think talking about beauty standards is valuable in FA for a lot of the same reasons that talking about health is valuable. Neither of them should be viewed as a prerequisite for being treated decently, but they’re both things that our fat-hating culture is busy telling us that we can’t have, and that we’re worthless because we don’t have. I really think the message of FA should be the same towards health and beauty both: neither is relevant to your worth as a person, both have value, and being fat does not disqualify you from either.

We’re allowed to be nuanced and multifaceted in response to cultural bullshit. It’s perfectly reasonable to say “That’s not true *and* it’s not relevant,” to messages like “Fat people are ugly” or “Fat people are sick.” Saying “That’s not true,” should not automatically make people assume that we’re agreeing that the statement is relevant.

Another aspect of this is that people as a whole are, unfortunately, pretty shallow. People who are viewed as attractive are more likely to be hired, more likely to be promoted, more likely to be viewed as smart or good. And looks discrimination is part of fat discrimination. It’d be an awfully hollow victory to have weight declared a protected class but to have “I didn’t refused to hire them because they’re fat; I didn’t hire them because they’re ugly,” be an airtight defense to accusations of weight discrimination.

So I see nothing wrong with trying to widen our definition of physical attractiveness at the same time that we challenge the notion that beauty has the slightest thing to do with worth as a person or is something we owe those around us. Just like I see nothing wrong with pointing out the errors and logical inconsistencies related to fat and health at the same time we challenge the notion that health has the slightest thing to do with worth as a person or is something we owe those around us.

Well, that went better than expected

So, I had my appointment with my new endo today, which I was more than a little worried about.

It went surprisingly well. No weight lecture whatsoever, even though I’ve gained 4 pounds in the past year (which the doctor said was “probably normal fluctuations.”)

My blood pressure was a tad bit higher than it had been the last time. Probably mostly the stress. The way being in a less privileged group interacts with having anxiety disorder is really unpleasant. I mean, I know I’m paranoid, but they kind of *are* out to get me. “They” in this case being the 60 billion dollar a year weight loss industry, most doctors to some extent, and even the freaking First Lady. So it’s difficult to use the techniques I would use to talk myself down from other worries, because this one is more grounded in reality.

On my patient consent form, I did cross out the “Pictures or video may be taken of me and used for educational purposes” line. I have no desire to be the headless fatty accompanying their Facebook post of some article on gastric bypass. (Odds are those are stock photos rather than their patients, but still, “education” covers a lot of ground that I may or may not be comfortable having my image used for.)

I hope this wasn’t a fluke, and that my follow-up in six months goes the same.

Doctors, Power, and Honesty

So, I have to make an appointment with a new endocrinologist, which I’m dreading the heck out of. (My previous endo finished her fellowship program and isn’t going to be at Hopkins anymore.)

With the previous endocrinologist, I pretty passively sat through a lot of weight lecturing because I really need someone to actually treat my thyroid issues. The previous one hadn’t, and I knew that if I got written off as the “non-compliant fat chick” there, I was pretty thoroughly screwed.

Since my current endo was extremely knowledgeable, polite, and helpful, I figured sitting through a yearly weight lecture and giving lip service to the idea of losing weight was a fair price to pay.

And, let’s be honest, I was freaking terrified. The power doctors have over you when you’re sick is a scary thing. I remember thinking, before I went to Hopkins, that if they blew me off like the last endocrinologist did, that my best option was probably to crash diet to lose 50 or 100 pounds, in the hopes that if I got down to a socially acceptable weight and was still showing hypo symptoms, someone would actually listen to me.

So, now that I need to make an appointment with the new fellow, I’m trying to figure out whether I’m brave enough to actually say I’m trying to approach my health from an HAES perspective, or if I’m going to just smile, nod, and get out with a prescription for the synthroid that keeps me functioning.

I may take a middle approach where I ask about research and studies without flat-out saying that I don’t plant to attempt weight loss under any circumstances. Because if you can show me a study where even half the participants lost a significant amount of weight, kept it off for five years, and didn’t experience worse health outcomes than the control group, I might be convinced to try *that* diet. To my knowledge, no such studies exist. But if I approach it from an angle of asking questions and being interested in evidence, I may be at least a little less likely to be blown off.

I’m also planning on going into the appointment dressed nicely and groomed as thoroughly as I would be for a job interview, make-up and all. It kind of is a job interview, where I’m applying for the position of “vaguely intelligent grown-up who’s allowed to make her own medical decisions.” And fat people, being supposedly stupid, lazy, and low-class, are generally disqualified from that position. So I’m going to shamelessly work on the markers that I can manipulate to be seen as a person worth helping.

I also have another medical thing going on. Polycystic ovarian syndrome, which seems to be preventing me from getting pregnant, despite a whole bunch of trying. (I kind of wish I’d known I had a condition that’s linked to infertility before I spent hundreds of dollars on BC pills that made me feel like shit, when we probably could’ve just used condoms and been more than fine.)

It’s been six months, which is the point at which you’re supposed to go to the doctor if you’re over 30. I’m thinking the first step will be to go back on metformin. I should also find out what other options are available if that doesn’t do it. I’m not keen on the idea of fertility drugs, since i really don’t want multiples. I also have my doubts that anyone would do IVF on someone with my BMI.

The one nice thing about the fertility stuff is that I don’t *need* to have a baby, not in the same way I *need* to have my hypothyroid managed. I want to have a baby, I will be very sad if I can’t have one, but my life will still be good. My awesome husband will still love me, I will still have a fantastic group of friends and a house full of furry critters. It would suck, but ultimately it would be okay.

That knowledge is a good thing, because it means that if any doctor I deal with in my quest to get knocked up is rude, or bullying, or manipulative, I’m completely free to walk away, in a way that I’m really not with my endocrinologist. I mean, I can walk away, obviously, but it’s not a risk I want to take unless I really have no choice.

It does make me wish doctors had a little more respect for their patients, particularly fat patients, and that they were a little more aware of the power they have over them.

How long can you hold your breath?

Just ran across the comment “If you regain weight, it’s because you eat more calories than you burn,” on Twitter. (It was from Suzanne Lucas, aka Evil HR Lady, whose unhelpful advice to fat job-seekers I’ve mentioned before.)

Technically, that’s a true statement. Your body can’t create adipose tissue out of nothing, and calories that are used through the day aren’t available to be turned into fat stores.

*But* there’s no guarantee that “more than you burn” isn’t still “less than you need to get through the day” or even “less than you need to avoid passing out.” (My first hint that the South Beach Diet forum I was participating in may have been a tad unhealthy was when people were talking about feeling faint and light-headed and experienced dieters responded, “Oh, yeah, that’s detox. It’s totally normal and it’ll be fine.”)

There’s also a limit to willpower. Sure, in theory, every bite you put in your mouth is a choice, but bodies are good at overriding conscious controls to do things that ensure survival. For instance, have you ever heard of someone holding their breath until they pass out? (There’s apparently a “fainting game” but it sounds like you need to press on the arteries in the back of your neck or have someone else make you hold your breath. So not quite the same thing.) Even toddlers throwing tantrums, if they pass out, it’s apparently breath-holding syndrome, where they stop being able to breathe. Not just that they hold their breath out of stubbornness until they fall over.

Similarly, pain tolerance tests are done by having the subject stick their hand in cold water (called a cold pressor test). The cap is usually five minutes, and between half to two thirds of people can actually make it that long. One interesting test showed that tolerances were the same whether participants were offered a dollar for every 15 seconds they could keep their hand in or only a penny per 15 seconds. (To me, that indicates that it’s a pretty involuntary thing, if money is no motivator when your test subjects are undergrads. Make it the whole five minutes and you can order pizza.)

So if you can’t hold your breath until you pass out, and you can’t hold your hand in cold water indefinitely, why would we think that most people could ignore hunger by sheer force of will, not just one day, but for the rest of their lives, eating only enough to keep them below their target weight (regardless of whether that’s enough to actually function on)?

I mean, sure, I “choose” to be fat in that there are things I can do that would make me temporarily less fat, and I might have a tiny chance of maintaining them permanently if I want to make it a part-time job. Or possibly a full-time job. I’d probably destroy my joints and my gall bladder in the process and further wreck my metabolism, but sure, that’s a choice. Not a choice I owe someone who doesn’t like looking at me. No more than I owe it to someone who doesn’t like looking at acne to take Accutane for the rest of my life. (I know, silly me, being selfish and wanting to have a family, rather than taking meds that cause fatal birth defects so I can fulfill my sacred female duty of being as attractive as possible to random men.)

And that’s really what it comes down to. Bodies, particularly fat and/or female bodies, are seen as public property, so in this bizarro-world, it’s reasonable to expect someone to reshape their whole life and risk their health to make their bodies culturally acceptable. And because it’s “a choice,” it’s totally okay to discriminate against those who can’t pull it off, or who aren’t willing to try because, you know, they aren’t masochists.

Doggie on a Diet

[Possible trigger for weight loss talk. Primarily about animals rather than people, but connected to diet culture.]

As I’ve mentioned before, the hubby and I foster dogs for a rescue organization. Our first foster, Reba, is now happy in her new home, and we have a second foster, Hershey Girl.

Hershey is an eight and a half year old beagle. She’s incredibly sweet, though shy at times and somewhat concerned about cats (largely because my cat Thomas is, well, kind of a butthead).

She has mammary tumors which we’re hoping are benign. Fortunately, they frequently are, but we won’t know anything until they actually do a biopsy. We’ll try to get her adopted out either way, but if she does have cancer, it will most likely become our job to make her remaining time as happy and comfortable as possible and be with her once it’s time to put her to sleep. (She belongs to the rescue, so that would be their call, not ours.)

Hershey Girl is also very fat. Average for a female beagle is 22-25 pounds, and she weighs 37. So, we’re going to try to help her lose some of that. Which, as you can imagine, is a little conflicting for me.

I know dogs aren’t people, and I don’t want to conflate the two or let my feelings about diet culture interfere with taking the best possible care of this dog that I can. And yet, I have to think that if it’s not as simple as “calories in, calories out” in people, is it really that simple in animals?

Heck, I know it’s not. I’m sitting next to a fat cat (Haley) who’s far more active than our other cat (Thomas). Thomas, however, isn’t fat. He has a bit of a belly, but mostly he’s just a big cat. Thomas, the leaner cat, is also the first to the food dish, the first to mew piteously if we haven’t fed him the minute we get up, and the first to get all indignant when we make food for ourselves and don’t give him any. But the fat kitty is also a spayed female, which tends to cause weight gain.

The other tricky thing is that dogs and people have very different internal cues. Dogs tend to be always hungry and not necessarily self-regulate. There are plenty of dogs who would eat their dinner, the rest of the bag of food, and everything vaguely edible on the counter if given half a chance. I know this isn’t true of all dogs (Diamond is sleeping next to a bowl with food left in it as we speak), but it’s pretty common.

People, on the other hand, are usually good at self-regulating if they have access to a variety of food and real permission to eat.

So, while it makes me a little twitchy, we’re going to count calories for the puppy dog, limit treats, and take her for lots of long walks. But, at the same time, we’re not going to focus too hard on weight loss. If a reasonable quantity of high-quality food and fun exercise doesn’t make her a smaller puppy dog, it’s possible that she’s just not going to be a smaller puppy dog, and I have no intention of getting sucked into the “weight loss at any cost” panic. Basically, we’ll worry about keeping her as healthy as possible, with the hope that healthy things will also lead to weight loss, which is likely to be good for a senior puppy dog’s joints and energy level.

She’s been in the shelter for a while, and she was surrendered because her people lost their house. So I imagine that she hasn’t gotten enough exercise for quite a while. And beagles don’t tend to be demanding about exercise, so it’s easy not to get them as much activity as they need physically. Our last foster, Reba, was a crazy, crashy, two-year-old pit bull. If you wanted her to be sane and not eat the couch, you would make sure she got a long walk and the chance to run around every day. Hershey Girl, on the other hand, gets excited when you put shoes on, but is pretty content to snooze on the couch all day. So, with all of that, I’m fairly confident that she’ll lose a few pounds once she has a chance to get plenty of walks.

Right now, she has kennel cough, so we won’t worry about weight stuff until she’s better. She’s currently on the all-chicken all-the-time diet because her throat seems to be bothering her and she wants nothing to do with kibble. I’m not sure Ellyn Satter’s awesome food pyramid applies to dogs, but “enough food” and “acceptable food” are definitely the first priority. And we’re being very conscientious about not pushing it on walks, because exercise aggravates the coughing. This is part of where health takes priority over weight.

I Stand With Fat Kids and With Planned Parenthood

Susan G. Komen pulled its funding from Planned Parenthood “because they’re under Congressional investigation.” Never mind that it’s not a legitimate investigation so much as a “Let’s shut down PP by any means necessary” witch hunt. And also never mind that Susan G. Komen grants go to cancer screeings, not abotions, and that Planned Parenthood is the largest provider of women’s health services in the country.

People have been coming up with new Susan G. Komen slogans on Twitter, and a lot of them are hilarious, frequently “in the I must laugh so I don’t cry or hit someone” sense. My favorite so far is “Does this coat hanger come in pink?”

I signed a petition, gave some money to PP, and am adding Susan G. Komen to the list of groups I won’t support. (It’s a short and esoteric list, including Chik-Fil-A and, as much as is practical, the nation of China.)

Speaking of petitions and donations, the awesome Ragen Chastain is *this freaking close* to posting a billboard in Atlanta to answer the hateful “Strong4Life” campaign. Donating to this campaign helps tell bullied fat kids that they’re not alone, unloved, and broken. We stand with them.

Marilyn Wann is also running I Stand Against Weight Bullying. Send her a picture and a slogan, and you get a nifty poster to spread hither and yon to show your support for kids of all shapes and sizes.

Holidays and Body Image

I just got back from visiting my parents for Christmas. It’s over seven hours’ drive between our place and theirs, so we don’t see them nearly as much as I’d like. I had a fantastic Christmas in pretty much every respect except the fact that I didn’t go to church. (Yes, I am a slacker. Yes, I have one excellent idea for a New Year’s Resolution, not that I ever actually keep those.)

My dad always makes a ton of food, because he loves feeding people. And there were no comments about this or that food being “bad” or judgment about who was eating what. Well, we did give my brother a little grief over his love of stuffing, but not in a “You shouldn’t eat that” kind of way. More in a “pass the stuffing to him *last* so the rest of us get some” way. And I ate what I wanted, not to the point of feeling gross or overfull afterwards.

And my mom, when she asked what size I wear for clothing gifts, didn’t say anything negative about the fact that I need a plus size. She just went out and bought me a gorgeous sweater (which I love).

I feel really blessed that my holidays weren’t a weight-related minefield, like so many people’s are.

It made me a little wistful to look at all the old family photos and see myself five, or ten, or twenty years ago. I thought of myself as a fat girl in high school, but when I look at my homecoming pictures, I see someone who’s a pretty average size. Kind of chubby arms, and a round face, but not what you would call fat. Probably wearing a size 14 at the time, so very average. And the pictures of me in college, I’d actually call thin, although I never felt that way at the time.

It’s strange to look at pictures that don’t reflect what felt like reality. But then, it’s not like I manufactured that feeling of “too fat” in my own head. That was what bullies said to me (among other insults, of course) all through later elementary and junior high school. I got called a whale, and all the usual insults. And my parents tried to help me with my “weight problem” and encouraged me when I dieted, and when I lost weight. So even when I wasn’t fat, I was viewed that way. But when I look back at actual pictures, I see a slender child become a chubby young teenager, then an average teen and a slender young woman (who then became an average, then chubby, then fat woman, helped by both regain after dieting and my thyroid throwing in the towel).

It seems like the negative messages are always louder and more prevalent than the positive ones. I’m sure I heard, implicitly or explicitly, that I was fat, or ugly, or weird, or gross, much more often than I heard that I was beautiful, or special, or loveable. Which is not to say that my parents messed up my self-esteem. Heck, my mom always had plenty of positive, encouraging things to say to me–they were just drowned out by the overwhelming onslaught of negative. The fact that I emphasized and magnified the negative and took it to heart, while discarding most of the positive, didn’t help.

I also think this ties into sexism. Our culture spends so much time teaching girls that their only value is a very narrow sort of beauty and that they can never be pretty enough, so of course when you’re told you don’t meet the standard, it hurts worse, and it sticks with you.

I didn’t mean for this to be such a depressing post, because I had a wonderful Christmas and am still having a fantastic vacation. But remembering how much I used to hate myself for not looking the way I thought I was supposed to look, well, it just seems sad. So much wasted time, so much needless pain. And I think that if we could figure out how to build a culture that doesn’t teach people, particularly girls, to hate themselves, that would be pretty awesome.

Hooray for Small Victories

Ragen at Dances With Fat posted about pointing out to Taylor Mali, one of her heroes, why one of the lines in a poem he wrote about health was problematic. It started off very positive and healthy-behavior oriented, and then threw in a line about “scores are dying because they’re getting fatter and fatter.”

Being disappointed by the people you look up to, whether they’re real friends and family or celebrities whose work you admire, sucks. I remember being really bummed when Alton Brown started getting really fat-hating, because I love his show and his recipes.

But this has a happy ending. She e-mailed, politely explaining why the line was problematic, and he *agreed with her* and said that he wouldn’t use the line if he performed the poem live.

I love it when people listen, when you get to see your words have a positive impact. It’s easy to get discouraged, because for every one person who takes your message to heart–whatever the message is that you’re trying so hard to get across–there are usually a hundred telling you to shut up and go away. But it’s worth pushing through, because not only do you occasionally plant a seed, you show others that it’s possible to stand up for what they believe in. It’s possible, and it’s worth doing. And oh my gosh did I need that reminder right about now.

Restaurant Portions

Kate Harding wrote a post about restaurant portion sizes, and how you don’t get to go “OMG, that’s why ur all so fat hur hur” in the very same breath as you’re noticing that people take leftovers home. That is, they’re generally *not* finishing that ginormous portion. Though, to be fair to the person who posted it, lots of people *here* fail to grasp the same concept and go on and on about the evils of portion sizes–yes, you get a freaking boat ton of food at a lot of restaurants; that doesn’t mean you have to eat it all. Honestly, I’d rather get too much than not enough, because I can almost always take leftovers home–if I’m still hungry, I have to order (and pay for, and wait for) something else.

I know they’ve done studies where people’s sense of how much they’ve eaten varies dramatically based on things like plate size and whether you’re eating out of a big communal bowl (of chips or popcorn, say) or an individual bowl or plate. The thing I have to wonder is how such an experiment would turn out if you controlled for dieting behaviors or an eating competence score. My theory is that the more you focus on external cues, whether that’s a calorie count or the amount of food on your plate, the less attention you pay to your own satiety signals. So, I’m thinking that people who have been doing intuitive eating for a while would be less affected by things like plate size than someone who hasn’t.

Granted, distraction plays a role too. One of the things that I’ve been working on lately is trying to take time at work to just sit and eat, rather than multitasking, especially if I’m eating something particularly filling. Because if I’m just eating and not paying attention, I go past comfortable and straight over to stuffed before I even notice. Though I will say that on the occasions when I do that, it’s a relief to think of it as a learning experience, rather than an “I’ve wrecked my diet and I’m a horrible person” experience. And it doesn’t happen often.

A Medical Rant

A friend of mine has a medical problem that has nothing to do with her weight, but her weight means doctors refuse to treat her. She was in a car accident and had her knee replaced years ago. the replacement is now shot, though it lasted much longer than it was expected to.

The orthopedic surgeon she sees wants her to lose *130* pounds before they’ll replace her knee. Not just come down under 250 pounds or out of the “obese” BMI category. They want her to drop more than half her body weight and get into the middle of the “normal” category.

Keep in mind that she can’t fricking exercise because her knee is shot. She’s doing good to walk around a mall or amusement park for an afternoon without needing a scooter.

The kicker, though, is the reason they give for not doing the surgery. It isn’t that she’s at a higher risk of complications or anything like that. No, it’s that the replacement will wear out a little faster. Really? Seriously? So you guys are okay with having her in continuous pain for the next couple *years* (assuming she can maintain what’s considered a healthy rate of weight loss, a pound or two a week) because otherwise she might need another new knee in twenty years rather than twenty five?

Not to mention how they can really think someone who can’t exercise is going to lose weight without pretty much starving.

It just boggles the mind that doctors can see someone in pain and instead of helping, basically go “Oh well, sucks to be you.”