"My daughter's not fat"

This kind of nightmare is what happens, folks, when we have mandated "reporting" of BMIs and other ridiculous "measures" of thinness/fatness. Especially for children, who are still growing and who do not grow in a linear fashion.

This particular incident happened in the UK. But it could easily happen here, now that states like Arkansas and New York require it, and other states are considering it.

You say that this is an extreme case? That overall, BMI reporting is a good idea? Read these talking points from the Eating Disorders Coalition.

Our language around these issues is loaded and complex, because we have made it so. We've made fat a dirty word that connotes so many negative qualities: lazy, greedy, sloppy, messy, stupid, unattractive . . . . No wonder 11-year-old Katie Owen reacted the way she did. She's not the first, and she will not be the last.

Brave Girl Eating: Q&A, Part II

The second part of the Q&A on Sheppard Pratt's blog is now live. I hope you'll check it out. Drop me a comment if you're in Baltimore and think you might make the reading--I'd love to meet you!

Brave Girl Eating: Q&A

In preparation for my upcoming book talk at the Center for Eating Disorders at Sheppard Pratt, the kind folks there are posting a Q&A interview on their blog over the next 10 days or so. Part 1 is up. And if you're going to be in Baltimore on August 25, please stop by the reading--I think it's going to be an inspiring event.

100,000 hits

When I started this blog in 2006, I had no idea I'd still be at it four years later.

Today, the 100,000th visitor stopped by the blog. I realize that's not a huge number, given stats on the big blogs. But for a little independent blog like this, it feels huge.

So thank you to my readers, those who agree with my opinions and those who don't, those who educate me and those who merely lurk. I am richer for having you as part of my community, and I hope I've offered something back in return.

As a way to say thank you, I'm going to run a book giveaway on the site. Stay tuned for details!

Don't get mad. Get out your Exacto knife.

That's what this furious citizen did when confronted by an offensive ad for thin pretzels.

What if we all "corrected" ads like this? They can't arrest all of us. . . .

Annals of retouching disaster: The Ann Taylor shirt

Thanks to a technical screw-up by someone at Ann Taylor (I'm thinking heads will roll over this), Jezebel was able to grab screen captures of a model before and after retouching.

Here's what the site ran:



You can see the work that's been done. As Jezebel put it, the "unretouched thumbnails . . . transform [models] into ribless monstrosities."

The model on the left--the unretouched one--is beautiful, shapely, and wears the clothing well. So why, why, why turn her into the absurd image on the right? I don't think it's enough to cite the pursuit of thinness. The model on the left is already thin--you can see her ribs, for God's sake. I think there's something more at stake here. Something that has to do less with beauty-qua-beauty and more to do with how women are perceived in 21st-century America--and how we perceive ourselves.

I can't help thinking about the timing of all these retouching debacles. There was the Calvin Klein photoshop disaster:



Then there was the Self magazine Kelly Clarkson debacle (see below).



Technology has something to do with it, of course. We photoshop because we can, because human beings are compulsive changers-of-reality and even more relentless self-improvers, and can't pass up an opportunity to "iimprove" ourselves.

Except that these kinds of "improvements" are so far out of the mainstream, no one (I hope) would confuse them with reality. Which brings me back to the idea that there's something more going on here.

Women have never been as powerful in America as we are today. And even though we still have a ways to go (can you say "woman president in my lifetime?), we've made enormous progress since I was a young thing. And thanks to the Great Recession, women's work and employment levels may be surpassing men's for the first time.

And maybe that's the problem. Maybe the Trojan Horse of self-loathing embodied in images like these is meant to put us uppity women in our place. I've said it before and I'll say it again: So long as we're obsessed with our appearance, our looks, how thin we are or aren't, we're missing the boat on a whole lot of more important issues.

I can't help thinking there's a connection.

Psychology Today

Over the next few months I'll be blogging over at Psychology Today as well as here on Feed Me!. PT has an impressive roster of bloggers who tackle some fascinating issues, and I'm honored to be among them. I'll link to my posts there, starting with my inaugural post; those posts will focus on eating disorders. I'll still post here about other issues of interest.

If you head over there and read the blog, and like it, leave a comment if you would--make me feel at home there. :)

Happy Monday!

Book tour!

The last few weeks have seen a lot of action on the book tour front. I'll be traveling quite a bit to readings, events, and conferences to talk about Brave Girl Eating: A Family's Struggle with Anorexia.

I thought I'd post an up-to-the-minute calendar of where I'm scheduled to be so far, with more to come. You can also look for my schedule here. If you come to a reading, please introduce yourself! I look forward to meeting some of you while I'm on the road.

8/24: Appearance on Good Morning America, 7 a.m.?
8/25: Reading at Sheppard Pratt Center for Eating Disorders, Baltimore, 7-9 p.m. in the conference center
9/20 The Book House, Albany, NY, 7 p.m.
8/26: Appearance on the Diane Rehm Show, 10 a.m.-noon
9/24: Presentation/book talk, Lake Forest College, 10 a.m., Lake Forest, IL
10/1: Reading/book talk, University of Wisconsin, Room 1244, Health Science Learning Center, noon
10/2: Reading/book talk, Wisconsin Book Festival, 10 a.m., A Room of One's Own Bookstore, Madison, WI
10/4: Reading/book talk, Moline Public Library, 10 a.m. (subject to change in location)
10/4: Talk/reading, Quad Cities Eating Disorder Consortium training for therapists, 3 p.m., Moline, IL
10/10: Presentation with Dr. Walter Kaye, National Eating Disorders Association annual conference, 3 p.m., Brooklyn, NY
1/21: Presentation/book talk, Maudsley Parents conference, University of California San Diego, 11:30 a.m., San Diego, CA

Poor Dr. Lundberg

Apparently Dr. George Lundberg is a little upset because back in 2004, he put forth his ingenious stop-obesity plan and it didn't work. And it didn't work, he tells us, because fat people just didn't listen to his plan, which is really simple and practical when you think about it. It consists of two words:

Stop eating.

Dr. Lundberg goes on to clarify what he means:

I did not say fast; I did not say starve. I said Stop Eating too much; stop eating high calorie snacks between meals, stop eating everything on your plate; stop eating such large portions; stop eating desserts; stop routinely eating bread and butter; stop eating three full meals a day when two are enough; stop eating fats and refined carbohydrates when you can eat fresh fruits and vegetables and complex carbohydrates.

And while you are at it, STOP DRINKING alcohol and sugary drinks.

I wonder if Dr. Lundberg understands anything at all about metabolism. If he did, I suspect he would not so angrily and aggressively put forth his diet plan--because that's what it is, a diet plan, one built on restriction. He would know that dieting, restricting, whatever you want to call it, ultimately makes people fatter, not thinner. He would show more sensitivity to the link between dieting (or restricting, etc.) and eating disorders. And I hope he would not so blithely recommend gastric "interventions," as he writes a few paragraphs farther down, which not only are often unsuccessful but which carry relatively high risks of death, infection, malnutrition, blood clots, and other consequences.

He writes rather plaintively, toward the end of his editorial, "A lot of obese people got really angry at me for hurting their feelings. But I don't really care that much, as long as we did get some people to adjust their eating and drinking behavior. STOP EATING and DRINKING EXCESSIVELY and STAY HEALTHY."

Tell me, Dr. Lundberg, what is "excessively"? To me it sounds like you think three meals a day is excessive. You think any amount of dessert is excessive. You think any amount of fats or refined carbohydrates is excessive.

Whereas actually, I think you're the excessive one. Your rules, restrictions, and most of all your rigidity and, yes, rage--what do these remind me of? Oh, yes, I remember. They remind me of the rigidity, rules, and rage of an eating disorder. You know, a lot of people think there's nothing wrong with having a little eating disorder, as long as you're not fat.

Those of us who have seen or experienced an eating disorder up close feel rather differently about that, of course. And I'll tell you what I think, Dr. Lundberg: I think you should confine your judgmentalism to yourself. You are free to eat and drink (or not eat and not drink) to your heart's content. You are free to manipulate your weight as much as you want.

And you're free to say whatever you want, of course, just as I am. But I hope to God, Dr. Lundberg, that you might educate yourself a little more before you spout off next time about obesity. I hope you'll talk to some people who know a little more than you about eating disorders and metabolism and all that complicated science-y stuff. I hope you'll talk to some families with children with eating disorders, and listen to them say their daughters and sons developed those eating disorders after middle school wellness classes that scared the crap out of them around being fat.

Until then, I hope you're not a practicing doctor anymore. I would hate to think of anyone I care about experiencing your judgmentalism, rigidity, and rage.

Guest post

Thanks to Amy L. Cambell for letting me write a guest post on her blog, A Librarian's Life in Books.

Campbell asked me to talk about why I wrote the book Brave Girl Eating: A Family's Struggle with Anorexia. I'm glad to have the chance to articulate it, to you as well as to myself.

Hop on over and visit Campbell's blog if you have a chance--I love supporting people who love books!

Distortions

When it comes to talking about eating disorders, there's no end to the distortions that often get trumpeted as "new." If you've had a loved one suffer with an eating disorder you know what I'm talking about. One of the things I teach my magazine journalism students is the fine art of taking a press release and turning it into a compelling and accurate piece of journalism. It's the toughest lesson we do all semester, which is no reflection on them. I think it's a challenging task to pull off, and very few news or public relations entities do it well.

To wit: This story from PR Newswire, whose headline trumpets "Mommy Not Always Dearest During Treatment for Eating Disorders." If you read only the headline and the first paragraph or two you'd come away with the idea that mothers were devastating, damaging, and destructive factors in their daughters' recovery from an eating disorder.

If you can force yourself past those first paragraphs, you'll be able to intuit a slightly more nuanced story. The family therapist quoted in the story, Catherine Weigel Foy, makes comments like "The mother-daughter relationship can be a complicated one." Um, yep. There's nothing particularly ground-breaking or earth-shattering in that statement. She goes on to say, "A mother's love begins before a child is born, and can create an unrealistic expectation that the connection between mothers and daughters will be as strong and free from limitations in adulthood as it was in early infancy."

I'll buy that, too, though perhaps I'm a bit more optimistic than Weigel Foy about the potential for good relationships between mothers and daughters.

Read down another paragraph or two and you find this:

Weigel Foy endorses an introspective look at this unique relationship and believes temporary distance from family members allows many adolescent and teenage girls to feel safe exploring the mother-daughter relationship in ways they haven't been able to during prior treatment for anorexia or bulimia. Weigel Foy and her colleagues at XX XX Residential Treatment Center work together to foster a nurturing environment that helps teen girls gain a realistic view of their relationship with their mothers. In turn, the girl and her mother are better equipped to support each other on their path to recovery.

Aha. Here, ladies and gentlemen, if we are attentive readers, the light bulb goes off. We understand that the piece we're reading isn't journalism at all but PR on behalf of XX XX Residential Treatment Center (I've deleted its name because I don't want to give it more publicity). Weigel Foy may be a good therapist or she may not; we really can't tell from this paraphrasing of her work in the service of publicity.

But certainly, the average reader will come away from the headline and opening paragraphs thinking, "Wow, this doctor thinks mothers are responsible for their daughters' eating disorder and/or get in the way during recovery."

Later in the piece, the writer concludes, "Through residential treatment and therapy this relationship can be explored and these young girls can come to better understand its affect on their diseases – and in turn help build a foundation for lifelong recovery." The mother-daughter relationship is being offered up as a reason to send your child to residential treatment.

Here I must point out that not only is there no evidence whatsoever that the mother-daughter relationship plays a causal or continuing role in eating disorders, but there is also no evidence whatsoever that exploring this relationship helps anyone get over an eating disorder. To the contrary: The most effective treatment for adolescent eating disorders is family-based treatment, which enlists the support of the family--mothers included--to help teens and young adults recover. And when I say "the most effective treatment," I am referring to real studies with real results, not one therapist's opinion (no matter how good she may be).

This kind of media deconstruction is important for everyone these days, as we're bombarded by information. But it seems to be especially imperative in the murky, vague, profit-seeking world of eating disorders treatment. Caveat emptor.

New website

Here's a huge shout-out to my talented husband, photographer Jamie Young, who is creating a new website for me. Take a look and tell me what you think--your input welcome! I'll be posting some of the fall events I've got lined up for the Brave Girl Eating book tour in the days and weeks to come.

The book is coming, the book is coming . . .

There seems to be some buzz building for the Aug. 24 release of my new book, Brave Girl Eating: A Family's Struggle with Anorexia. I feel honored! And I wish I had galleys to send out to everyone who wants to read it. (My publisher would like me to say instead, "I wish you would all buy it!")

So I thought I'd post a link here to the incredible book trailer a student, Shelby Haddon, made for me last spring. It uses some of the material that opens the book.

In the weeks to come I'll post short excerpts from the book. Of course I wrote the book and I want it to find an audience. But beyond that, I want it to make an audience--people who don't know much about eating disorders except what they hear on the news or in magazines. Why should they care? Because chances are, someone they know and care about has an eating disorder but isn't talking about it. People feel shame and stigma about having eating disorders, and unfortunately the secrecy around them feeds the flames of that kind of stigma.

No more secrecy. No more stigma. I believe in telling the stories, true stories. People need to know and understand and empathize with what other people are going through.

Enjoy the trailer.

Looking for young adults with anorexia

Researchers at the University of Chicago, under the direction of Dr. Daniel le Grange (pictured, left), have just won an NIH grant to study family-based treatment (FBT, also known as the Maudsley approach) in young adults. If your family lives in the Chicago area, or within driving distance, you could get free treatment if you qualify for the study. Not to mention the chance to get some of the best treatment for anorexia in the country. It's a win-win!

Here are the study parameters:

This study is a good match for you if you are:
• 18 to 25 years old
• Meet diagnostic criteria for anorexia nervosa
• Are prepared to participate in assessments
• Interested in cost-free psychotherapy treatment with a family member of choice

Treatment involves up to 6 months of free individual and family therapy sessions.

For more information, please contact the Participant Coordinator at 773-834-9120 or visit University of Chicago here.

Michelle Obama: Starting to get it?

Maybe so, if this story from the Christian Science Monitor is to be believed.

The First Lady goes on record saying she "tries to stay away from discussions about weight with her daughters," focusing instead on health. Though I notice she's still willing to talk about weight with the rest of our daughters. And sons.

Well, change comes slowly. Good start, Mrs. Obama! I hope you'll keep listening as well as talking. And if you've got another place at the table for your September summit on childhood obesity, please count me in. . . .



PHOTO CREDIT: AP PHOTO/ED ZURGA

UC-SD is looking for research participants

One of my next posts is going to be a love letter to the team at UC-San Diego.

Meanwhile, if you live on the west coast and would like to participate in a brain imaging study there, please consider doing it. The folks at UC-San Diego, under the direction of Walt Kaye, are doing some of the most important cutting-edge work on the neurobiology of eating disorders. This is your chance to help them out, get a scan of your brain, and make a little money. Details are below.


RESEARCH PARTICIPANTS WANTED
In conjunction with Dr. Walter Kaye and his research team, Dr Amanda Bischoff-Grethe is seeking female participants between 12 and 18 years of age who have a recent (within the last six months) diagnosis of Anorexia Nervosa. Qualified participants will be asked to answer questions regarding their personality and cognitive abilities and will also undergo a 1.5 hour brain imaging study. By participating in this research study you may assist physicians and researchers in developing treatments for these complex and serious disorders. You may be compensated up to $175 dollars plus mileage. For more information, please contact the UCSD Eating Disorder Treatment and Research Program at edresearch@ucsd.edu or the Research Coordinator, Zoë Irvine, at 858-246-0699. We look forward to working with you!

Independence Day

July 4th is a time to celebrate freedom: freedom from tyranny, from oppression, from authority. These are concepts we typically think of in the context of politics. I've been thinking about a different kind of freedom this year: freedom from eating disorders.

The analogy is apt, though most people don't know it. Having an eating disorder is like being a slave, subject to the whims and demands and impossible expectations of a taskmaster well-versed in the art of punishment. When you have an eating disorder, you do what it says, whether that's to refrain from eating even though you're starting, or to purge every calorie you do eat, or to stay awake when you're exhausted (because you don't deserve to sleep/eat/live). Having an eating disorder is the very opposite of freedom. You're not free to choose when it comes to some of the most fundamental elements of your life.

Anyone who's had an eating disorder can tell you that it's not a choice. You are not exercising free will every time you stick your finger down your throat, or push away a plate. You're in the grip of an irrational tyrant who has no regard for your feelings, your health, your sanity.

So this July 4th, I'm thinking about everyone who's ever struggled with an eating disorder, who's felt the iron grip of tyranny around her throat, stomach, mind, and who is struggling to become free. I want you to know that you can become free. There is hope. There is life outside of the crushing oppression of an eating disorder.

And here's to it, and to you.

Project BodyTalk goes live!

After nearly a year of development and work, I'm pleased to announce that thanks to my fabulous graduate assistant, Megan Swann, we've got a website up and running for Project BodyTalk. I've been writing about eating disorders for a while now, and at some point I began thinking that it would be really fabulous to be able to hear the actual voices of people who struggle with EDs. I'm also a radio devotee and big fan of shows like This American Life and the StoryCorps project.

From these sources, Project BodyTalk was born. It's an audio project that collects commentaries on the subjects of food, eating, body image, and eating disorders. Here on the Syracuse University campus, we opened a recording booth for a couple weeks last fall and collected a number of commentaries from students, faculty, and community members who came up to campus to record. Since then I've had people send me mp4 and mp3 files. A couple of teachers at a high school in Baldwinsville had students record commentaries.

The first commentators were told to record a commentary anywhere from 1 to 10 minutes, on any related subject. Some people told stories about friends and family members struggling with body-related issues. Some talked about foods they love. Some talked about what it's like to be fat, or thin, to have anorexia or binge eating disorder, to feel pressured to look a certain way. It's turning into a wonderfully eclectic, diverse, and moving project.

So . . . the website is up and running with the first half dozen commentaries. Over the next few months I'll be editing and uploading more commentaries, and, I hope, collecting them too.

We've also got a page labeled ACT, where I'm posting links and descriptions of other body-positive projects. If you've got one to share, send me info, and I'll happily add yours to the page.

I'd love your feedback--and your commentaries.

*Image by Megan Swann.

Bring Brave Girl to your town!

I've started planning a book tour in earnest for BRAVE GIRL EATING, my memoir about our family's struggle to help our daughter recover from anorexia. My goal: To visit as many towns, especially university towns, as possible, and to get in front of as many pediatricians, doctors, therapists, and families as I can.

Here's where you come in, dear readers: I need your help arranging events in your town. I'm aiming to get on the schedule for university lecture and talk series, because I know this book will be of interest to both the scientific community (it's got lots of science and neurobiology for all you geeks, and I count myself among you) and to college audiences. The best way for me to make contact with folks around the country is through someone who's already in the community and who can broker an introduction and help me connect with the right person.

I'd love to come speak in your town, at your university, in your state--hell, in your doctor's office. So if you can help please let me know. My email addy is harriet at harrietbrown dot com. Tentative schedule to come in the next few weeks, I hope!

Are you a size-accepting fat woman?

If so, please consider helping grad student Micheala Null, a doctoral student in sociology at Purdue University, by taking a brief study and potentially doing an interview. Details are below.



*********************

Call for Participants

Hi, my name is Michaela A. Null, and I am a doctoral student in Sociology at Purdue University. I am doing a study about the embodiment of size-accepting fat women, with attention to the ways in which gender, race, sexual orientation, and
body size intersect.

I am currently looking for individuals who are interested in volunteering to participate in my study. If you are interested in volunteering to participate in an interview, I ask that take an electronic informational survey, which will take approximately 5 minutes. Please go here and complete the informational survey. After all survey data has been collected, participants will be selected for interviews, which will be conducted in-person, by phone, or via internet chat, and will last between an hour and an hour and a half.

Participation is voluntary and participants must be at least 18 years old.

This project has been approved by my university’s Institutional Review Board, which protects human subjects of research. I will provide confidentiality to all volunteers and participants will be referred to by a pseudonym in all research documents.

If you have any questions regarding this study, you can contact me at mnull@purdue.edu. For more information on me, you can access my university profile here.
You can also contact Professor Eugene Jackson, Assistant Professor of Sociology at Purdue University, at jacksone@purdue.edu.


Sincerely,

Michaela A. Null
Doctoral Candidate
Instructor for Women's Studies
Purdue University
Department of Sociology
700 W. State Street
West Lafayette, Indiana 47907-2059

Check the Huffington Post . . .

for my response to the White House Task Force on Childhood Obesity.

Add your comments, please. I'm sure there will be plenty of the wrong kind up shortly.

Kudos to the eating disorders work group on DSM-V

for deciding not to make obesity a disease in the next edition of the Diagnostic and Statistical Manual of Mental Disorders.

This decision has significant ramifications for how docs treat and to some extent see obese patients. I'm a big proponent of changing the dialogue around obesity from a discussion of weight to a discussion of health. The two are not synonymous. I'm also hoping this will stop bariatric surgeons from marketing their surgeries as eating-disorder treatments, for instance.

The group also recommended changing criteria for anorexia and bulimia:
• Now patients must weight 85% of ideal body weight or less for a diagnosis of anorexia; in future, if the changes go through, the criterion will be "restriction of energy intake [leading to] markedly low weight." This rightly shifts the emphasis from the rigid weight characteristic to a pattern of eating and relationship with food. Now insurance companies will have a harder time cutting people off from treatment once they hit 86% of ideal body weight.
• Loss of menstrual period is no longer one of the criteria for anorexia. Some women never lose their period, no matter how thin they get; others keep menstruating even at very low weights.
• Bulimia will be diagnosable with purging episodes of once a week; right now, the criterion is two episodes a week.
• Binge eating is likely to become a diagnosable eating disorder.

New film: Fat

A filmmaker named Jennifer Jonassen sent me a link to this trailer for a new documentary, FAT, due out later this year. I think it looks pretty interesting. What do you think?

"You're so fat!"

The car was a beat-up sedan crammed with college kids--guys--who had clearly started their Saturday night partying on Saturday afternoon. My husband and I were out for a short three-mile bike ride. I heard the guys yelling and carrying on from a block away, and I knew they would yell something at me. And they did.

"You're so fat!"

As I pulled up alongside my husband, he asked, "What did they say?" When I told him, his jaw dropped.

"I can't believe they would say something like that!" he fumed.

I could. And as I told him, it didn't bother me all that much. I'm used to it. Guys have been yelling things at me since I was 15. Like any woman, I've learned to tune it out. It's a power trip, a form of misogyny, a reminder that women are vulnerable to men in a variety of ways.

Still, I thought about it all the way home. It reminded me of the way boys at my junior high school used to drop pennies on the ground, and yell "Kike!" at anyone who picked one up. And with that recollection, I realized viscerally, profoundly, and in a deeply emotional way that what those guys in the car were doing has a name: hate speech.

And although I've been thinking and writing and talking about this subject for years, I think this was the first time I truly got it in a fundamental way. And that is something I'll be thinking about for weeks to come.

Book trailer

A very talented student at Newhouse, Shelby Hadden, created this trailer for my forthcoming memoir, BRAVE GIRL EATING: A FAMILY'S STRUGGLE WITH ANOREXIA. Isn't technology great?

Let me know what you think.

One more reason NOT to get bariatric surgery

Bariatric surgery--the practice of deliberately mutiliating the gastric anatomy in order to lose weight--is being pushed harder than ever these days. The latest claim: it cures Type II diabetes instantly.

Not so fast. Apparently the issue is more nuanced than that. Researchers at the University of Washington recently found that people whose fasting blood glucose levels came down after having the surgery were still spiking diabetes-level glucose levels after meals.

The money quote:

"I don't think the procedure cures whatever it is that's causing diabetes in the first place," said Arthur Chernoff, MD, chair of endocrinology at Albert Einstein Medical Center in Philadelphia, who wasn't involved in the study.

SHocking, isn't it? Fat may not be the only cause of diabetes.

In fact, the weight-diabetes link is one of doctors' strongest arguments against fat acceptance and health at every size. Bariatric surgery is very serious business--and I mean that in both senses of the word. It's a multimillion-dollar industry based on the premise that it's a good idea to take out part of your guts--forever. Once you've had the surgery, your body is unable to process nutrients the way it used to. You may or may not become thin (some people lose weight only to regain it after); you may or may not experience some of the serious complications of the surgery; you will be permanently malnourished.

And now you may not have an instant cure for Type II diabetes after all. Because the equation may be a bit more complex than fat = bad, thin = good.

Bravo to Gawker

That sound you hear? It's me clapping for this tell-it-like-it-is piece from Gawker, which deftly skewers the mainstream media's not-so-hidden obsession with thinness.

My favorite quote:
The purpose of working out is get in shape. Not to get "thin." To be in shape, for the average person, connotes being healthy, and improving on the basic elements of one's own fitness: muscular strength, endurance, cardiovascular, flexibility, etc. . . . designing a workout and nutrition program with the goal of being thin will almost certainly ensure that you cannot achieve a high level of fitness; you would eat a low-calorie diet, thereby robbing yourself of muscular gains.

Note that I deleted a sentence or two in here. Even Gawker falls prey to the knee-jerk obesity-is-bad syndrome. (We really have to have a chat about that, Nick Denton.) But it's not so easy calling out the Gray Lady herself on the assumptions and obsession with thinness. So kudos to Gawker, and Hamilton Nolan, who wrote this post. Let 'em know what you think.

Fat and thin: It's all in your brain?

A new report from Brigham Young University suggests that women may be hardwired to worry about body image. Using functional MRI scanners, which record which parts of the brain light up while it's engaged in a task, researchers have discovered that women's brains react differently than men's to images of fat and thin. Study subjects, who were all thin, passed a screening test for eating disorders and so were presumed to have no overwhelming body image concerns.

When women were shown images of overweight women and told to imagine that someone commented that they looked like the woman in the image, a part of their brains that engages in self-reflection lit up. When looking at the images, says Mark Allen, a neuroscientist at BU, "women are actually engaging in an evaluation of who they are and whether they are worthwhile as a person. Even though women might claim to be well adjusted and not care about body issues, subconsciously they might care."

But couldn't this be the result of the overwhelming socialization American women experience on the subject of fat? Would the brains of women in a different culture--a culture that didn't put so much value on the thin ideal for women—light up the same way?

I'm not a neuroscientist, but I wonder if this study is flawed. Or maybe I simply don't want to accept that there's a biological limit to self-acceptance on this issue.

I'd love to hear what you think.

Britney does Photoshopping

Kudos to Britney Spears, of all people, for releasing some before and after photos of herself--before and after airbrushing and photoshopping, that is. She's the latest in a trickle of celebrities doing this. It's a commendable effort, even if, as Jezebel rightly points out, the before images are still unrealistic, thanks to makeup, lighting, and other props ordinary women don't have when they look in the mirror.

Still, it's a start, a small stone rippling the surface of the unattainable thin ideal. Me, I'm hoping for the rockslide. Any day now.

Health Care for the Obese

A new study published today reports that overweight and obese patients get the same or better quality of health care than "normal" weight patients.

Researchers at the University of Pennsylvania say they looked at quality of care across eight performance measures among Medicare and VA patients, and found no difference in the kinds of treatments doctors prescribed for obese and non-obese patients.

According to a s tory on MedPage Today, "Performance measures included diabetes care management (such as lipid and HbA1c monitoring and eye tests), pneumococcal vaccination, influenza vaccination, screening mammography, colorectal cancer screening, and cervical cancer screening." The story goes on to quote one of the researchers commenting that while doctors do "harbor negative attitudes" toward heavier patients, that prejudice doesn't affect the quality of care delivered.

I think this is a pretty grandiose conclusion to draw from such a limited study, and the researchers themselves cautioned against extrapolating these results too broadly. To me, the study raises some interesting questions: Are doctors more tolerant of overweight vets and/or poorer patients? Is "quality of care" strictly a function of which treatments are recommended?

I don't think so. I wonder what the patients would have to say about the quality of care they received--not just the treatment recommendations (which are of course important) but the relationship they had with their docs, and how it affects their long-term care. I wonder whether these two populations typically have long-term relationships with the same doctor, or whether they often see a revolving cast of medical providers, and whether that might make doctors react differently to them than to patients they see regularly.

Thoughts?

Warning: The Images You Are About to See May Be Damaging to Your Health

I'm a big fan of Jezebel, but I think they've got it wrong this morning. In a post discussing a recent editorial in the Daily Mail by grieving mother Rosalind Ponomarenko-Jones, whose 19-year-old daughter died of anorexia, Margaret Hartmann argues against the notion of labeling photos of celebrity "twiglets" when they get too thin.

Ponomarenko-Jones argues against the current appearance-driven culture, which calls out celebrities not for achievements but for appearance. And "calls out" is the right expression, since we're all familiar with the standard scary-skinny-celebrity story these days: Publish a photo of a woman so emaciated that it's painful to look at her, along with a headline that screams a fake concern for her well-being. The whole exercise feels prurient and voyeuristic.

Hartmann centers her argument on the logistics and legality of the question: How would we determine when a celeb is "too thin"? How would we know when to label an image and when not to? It's a valid point. And before commenters jump on me for this, I acknowledge that you can't tell whether someone has an eating disorder just by looking at her. Some people are naturally skinny, and there are other reasons (other illnesses) for gauntness.

But Ponomarenko-Jones has the moral high ground here, and I wish there were a way to honor the spirit of her request. Because we (and by "we" I mean the media) don't go around publishing photos of, say, recent cancer victims, who may be every bit as scarily skinny as an actress in the grip of anorexia. Yet magazines and websites are full of images of "twiglets," young women so thin you can see the shape of their femurs. Why is it OK to publish these images and not, say, images of Farah Fawcett as she lay dying of cancer?

It comes down to our blindness to eating disorders as "real" diseases. We would cringe at the idea of violating Fawcett's privacy in that way. Yet the young celebrities who walk so scary-skinny among us are dying of an illness, too, an illness that will kill them as surely as cancer killed Fawcett. The difference is that with treatment, many of these women can recover; for Fawcett and many other cancer victims, alas, treatment did not save their lives.


And of course treatment won't always help with eating disorders, either. But the point here is that instead of parading these images as models for women--whether this is openly acknowledged or not--we should label them for what they are: images of the gravely ill, who are struggling with their own terrible reality and heart-breaking health battles.


Jezebel got it wrong. The real shanda (as my grandmother would have said) is that we pretend there's no such thing as too thin.

Conference in Chicago--register now!

In just over two weeks Maudsley Parents will sponsor its second conference on eating disorders--this time in Chicago. This one-day conference, aimed at parents, therapists, and researchers, features some of the best thinkers on eating disorders in the country--including Dr. Daniel le Grange and Dr. Walter Kaye—plus a panel of parents who will talk frankly about what they know about combating their children's eating disorders.

It's going to be a fabulous event. I'll be there, along with my two partners in crime from Maudsley Parents--Jane Cawley and Ann Farine. We've worked hard to keep it affordable so everyone who wants to come can manage it.

For more information or to register, click here. We'd love to see you in Chicago!

Book Giveaway: 100 Questions & Answers About Anorexia Nervosa

Dr. Sari Shepphird is one of my favorite "experts." Shepphird, a clinical psychologist from Los Angeles who specializes in treating eating disorders, has a new book out, 100 Questions & Answers About Anorexia Nervosa. The book tackles the complex and confusing subject of eating disorders by posing and answering questions like "Are athletes at greater risk for developing anorexia and eating disorders" and "How do I know if I have a healthy body image?" The book is written for people with anorexia, their friends and families. I admire its clear, practical approach, and think it will be of great help to many.

And I've got a copy to give away! If you'd like to enter the drawing for a free copy of Dr. Shepphird's new book, leave a comment on this post telling me why you're interested in reading it. I'll draw names at random next Monday, March 29.

Good luck!

A troll among many trolls

I don't normally bother with trolls, but this one sent me an email to my work address that is so vile, I have to share it here with all of you.

Barry, I suspect you are what I think of as a self-loather. Maybe you were once fat. Maybe you're fat now. Maybe you're deathly afraid you will be fat in the future.

Personally, I love how you toss aside research in favor of your own baseless and warped opinions. That Barry, he sure knows better than those high-falutin' doctors who actually research this stuff!

Since you think shame is a good health-care strategy, I'll take your idea a step further and see if shame is a good strategy for curing haters like you. Probably not, alas.

I hope my readers will respond to you in the same spirit in which you wrote to me.



I was mystified and angered by your article in the Times today. Are you actually arguing that obesity is a healthy lifestyle? Are you really saying that fat people have no control over their food intake and amount of exercise? Eating too much is nothing to be proud of, just as drinking too much alcohol is nothing to celebrate. You are lying to yourself if you think you are not shoving far too many calories into your mouth. You're fat because you can't control yourself--it's that simple.

The reason we stigmatize obesity is because it really is a choice, unlike skin color, ethnicity and the religion you were raised in. Obesity is a signal to others that this fat person is living an important part of his/her life totally out of control. It signals a lack of self-discipline and a warped sense of self-worth. Your position on this means means you're proud of your lack of control about how much, and what, you eat. It's delusional to be proud and pleased that you are out of breath when you climb stairs, that you are heading for a horrible old age--if you live that long, that making love to your partner is a problem instead of a happy event, and that you can't perform simple tasks from properly wiping your ass on the toilet to picking up an earring you've dropped.

Delusional: For example, you state that the emotional stress of the prejudice against fat people causes the health issues that result from obesity. That is not science, that is nonsense. We know stress can be a contributing factor to poor health, but you're trying to blame others for the conditions you create by eating too much. Reminds me of alcoholics saying they drink too much because of all the pressure on them to stop drinking.

On the one hand you blame doctors for relating to obese people differently than normal weight folks because, as you say, doctors believe fat patients won't follow orders, won't show up for appointments etc. Then later in your article you say fat people don't show up for doctor appointments because they feel bad about themselves and worry about how doctors will relate to them. Doctors know from experience that fat people miss appointments and can't or won't take care of their own health. Of course they relate differently to people like you who disdain main stream medical advice.

When Lincoln University tried to help fat kids get well and avoid incipient heart and other diseases, you condemn them for their efforts. What you fail to understand is that your stance actually kills people by making gluttony and self abuse through food a good choice, a choice to be proud of. What you are doing diminishes the real harm of prejudice which punishes innocent people for the color of their skin or their ethnicity--things they can't and should not want to change.

But obesity is a lifestyle choice, like smoking and alcoholism, a self-destructive lifestyle choice that harms the people who choose to follow that course. Anyone can get thinner and improve their overall health. It is not easy but rarely are the important life choices easy. That doesn't make your choice a virtue. It is difficult to diet and exercise on a regular basis and change your attitude about stuffing as much food as you can into your face. We've all heard the reasons people live your way, and none of them are good, abuse as a child, the comfort derived from eating lots of fatty creamy things, the hit of sugar, the bad habits of a deprived upbringing blah blah blah. We rightfully despise drunks who abuse themselves and others, ruin careers and the lives of those who love them. Similarly obese people are wearing a big sign that says "it's all about me and screw you who object to my overeating, it's costs to society, it's bad example to young people, it's strong signal that I'm out of control. I do it because it feels good and I'm proud of that." This is called selfish and irresponsible--nothing to be proud of.

Think about the damage your article has done. Making a virtue out of a lifestyle that any scientist, medical person or just plain educated folks know is harmful. Shame on you.
Barry XXXX
NY

PLEASE NOTE: THIS THREAD IS NOW CLOSED.

The stigma of obesity

I'm delighted that the New York Times has run this piece, even though they cut the fabulous Marilyn Wann from my final draft.

Let me know what you think. And if you're feeling brave, venture on over to the New York Times' blog discussion of it. It's a stunning example of how deeply ingrained fat stigma is in our culture. Sheesh.

And a big welcome to Jezzies who land here. Love the photo of Gabby that ran with the post today.

Protest in D.C. today

If you're in Washington, D.C., today, check out this protest against the insurance industry. Activists plan to "arrest" health insurance execs who are there for a meeting, and hold a rally afterward.

The idea behind the event, according to Gerald McEntee, president of the American Federation of State, County, and Municipal Employees (AFSCME), is "to expose the high crimes and misdemeanors perpetuated by the insurance industry time after time and year after year, and we are totally sick of it. We're going to crash their party and put an end to its injustice."

I'm with you in spirit!

The U.K. tackles body image issues

Kudos to the Royal College of Psychiatrists across the pond for taking on the thorny issue of media and body image in a powerful way.

The U.K. group just issued a statement admonishing the media for their damaging portrayal of eating disorders. That's good, and it goes along with similar statements made recently by several U. S. groups. Raising awareness on both sides of the pond--excellent work.

The RCC's gone a step further, though, calling for a "new editorial code" that would end the promotion of the unattainable thin ideal in the media. This is a bold step, and I'm going to be following developments closely on this subject.

The RCC identified three main areas of concern (and I'm quoting here from its press release, as you can no doubt tell from the Anglicized spelling):

Visual imagery: Preteen or underweight models are used by the media and advertising companies to promote a thin body ideal, and airbrushing and digital enhancement is widely used to portray physical perfection that is unattainable in real life.

Unbalanced articles : Many magazine articles give advice on dieting without giving information about the long-term effectiveness of diets and the dangers of extreme dieting. ‘Body critical’ articles also target celebrities for being overweight, underweight or physically imperfect, which normalises body criticism and can make people dissatisfied with their own bodies.

Inaccurate portrayal of eating disorders: Many articles ‘glamorise’ weight loss and portray eating disorders as mild disorders or personal weaknesses, rather than serious mental illnesses requiring specialist treatment.

I'm expecting cries of First Amendment foul on this side of the pond. It raises an interesting dilemma for me, as both a magazine journalist (and professor of magazine journalism) and an eating disorders advocate. Is censorship ever a good idea? How about self-censorship, which I think is what the British shrinks are suggesting?

My journalism colleagues will no doubt want to throw me off the island for saying this, but I'm all for some kind of self-censorship in this case. No journalistic standards will be violated if, for instance, magazines ran images of beautiful 20-year-old American models instead of emaciated Russian preteens with preternaturally pouty lips. In fact, I could argue that in the best possible tradition of journalism, magazines have a responsibility to tell both sides of the story: Instead of blaring the trumpets of weight loss at any cost, how about stories that encourage women to accept and love themselves as they are? I'm not even gonna mention the kind of cognitive dissonance that comes from Photoshopping the hell out of Kelly Clarkson on the cover and then running a feature quoting her as saying she loves her body the way it is and doesn't feel the need to diet herself into oblivion. I'm not even going to mention the magazine that did this (cough, rhymes with elf).

When I pitched a story on self-acceptance and body image recently to a magazine that shall not be named (cough, rhymes with wealth), I was told by my editor, rather sadly, that it would never fly.

Maybe when pigs grow wings.

**Thanks to one of my students, Courtney Egleston, for posting this story originally on the Newhouse magazine feed.

Jezebel investigates MeMe Roth!

Check out this awesome post by Jenna over at Jezebel, who as far as I can tell is the only journalist who's actually bothered to investigate Roth's pseudo (cough fake) credentials for her ridiculous one-woman anti-obesity campaign.

As a professor of journalism and writer for mainstream media outlets, I'd love to know why no one else has even questioned Roth's patently false claims and unsupported stance. How about Nightline, which pitted Roth and a chick named Kim Bensen against Marianne Kirby and Crystal Renn in this "faceoff" questioning "Is it OK to be fat?"

I can't help but think this is a) an example of how sloppy some journalists are getting, and b) a function of the widespread fatphobia washing through the culture.

Either way, kudos to Jezebel for doing some actual reporting. And, of course, presenting that reportage with the requisite levels of snark and sarcasm.

The Woman at the Y, part 4

She was back again. The woman at the Y. I thought I was ready. I'd talked to myself about it. I'd told myself, It's her business, it's her life, I don't know her story, and anyway, there's nothing I can do. So when she took up a position right toward the back of the room this morning, I made myself look away from her in the mirror. I did OK.

But five minutes later, I looked at the mirror and she had somehow moved up in the class. She was now directly behind me, close enough to once more see the shape of her thigh bones through her pants, see the strained and straining look on her face. When the song ended I moved across the room, to a spot where I couldn't easily see her. I thought I was doing OK.

And she took off her shirt.

Understand, this is not a class where people take off their shirts or exercise in their sports bras. I've never seen anyone else do that. Not that there's anything offensive about the idea of working out in a sports bra; it's just not the culture of this particular class. So her action would have been startling no matter who she was or what she looked like.

Now everyone could see the shape of every rib, count the knobs of her spine, consider the impossibly small diameter of her waist.

I fled. I ran out of the room clutching my water bottle and sat in the bathroom of the Y and cried.

I'm sure at this point that she knows that her presence disturbs me. As a friend later said, it's as if she's a specter, haunting me. As if I needed haunting. As if I needed reminding of everything anorexia has taken from the people I love and care about.

I won't be going back to that class.

Comments have been disabled on this blog post only.

Why Dick Cavett needs a muzzle. Or maybe a gag.

I used to like Dick Cavett. Of all the talk show hosts, he was the one known for his erudition, his intellectual streak. Johnny was the funny one, but Dick was the insightful interviewer, the one who came up with the best questions, whose show made you think.

I haven't been a fan of Dick's in a while, ever since he wrote this truly obnoxious blog post on obesity. Cavett's not the only painfully thin celebrity to weigh in (ha ha) on the subject, and he won't be the last. But his blog post seemed especially egregious to me, maybe because he wasn't responding to a current event, or an interviewer's question. He was just flying his fatphobic flag, loud and proud. By using words "heavily larded," "a herd of heifers," "the size of the Hindenburg," and other choice descriptors, Cavett showed off not only his vocabulary but his jejune perspective. (No, Dick, you're not the only one who knows fancy words.)

I thought I was over Dick Cavett. I really did. It's hard to stay pissed off at a washed-up ex-talk-show-host who's got nothing better to do than vilify people based on their appearance. Then he ticked me off all over again with a quote in this week's New Yorker magazine, in a piece by Ben McGrath on an odd little throwback of a recruitment video recently released by Yale.

McGrath quotes various Yale alums on the pros and cons of the video. Their comments are informative and amusing. That is, until we get to Cavett, who says, "“I wonder if it really was made in America, because there are no fatties.”

Really, Dick? That's your reaction? That the video features "no fatties"? What does that have to do with the subject at hand?

It seems that Cavett just can't put a lid on it; he's got to inject a little fatphobia into every conversation in print. Mercifully, there aren't too many of those, because, after all, he hasn't actually done anything worth mentioning in about 25 years. Maybe he's trying to line himself up a reality show. Maybe he wants to replace Howard Stern. Or maybe he's so obsessed with the subject of fat people that he literally can't help himself.

In which case, Dick, let me give you a few words of advice: Shut up already. You may have a high IQ, but your comments illustrate your ignorance, your prejudice, and your inherent lack of decency and kindness.

Come to think of it, maybe Rush Limbaugh has a co-host spot. Dick Cavett would be perfect for the job.

Ditching the concept of "refusal"

The editors of the venerable Diagnostic and Statistical Manual of Mental Disorders, otherwise known as DSM, have just released proposed revisions for the fifth edition of the book, due out in 2013. And WOO-HOO! They've taken out the word refusal in their criteria for anorexia nervosa.

That word has always bugged the crap out of me. It embodies everything I've come to dislike and distrust about conventional eating disorders treatment. It assumes that the person with anorexia is making a choice--a conscious choice--to not eat. It reinforces Hilde Bruch's characterization of anorexia and the people who suffer from it and the whole psychodynamic theory of AN--a theory that has absolutely no basis in scientific evidence or fact. A theory that has kept ED treatment in the 18th century, in my opinion, and condemned sufferers to years of ineffective treatment and torment.

So three cheers to the editors. I hope their proposed revisions make the final cut.

NEDA Walk in San Diego

You don't have to be in San Diego to support the first annual San Diego NEDA walk, which will be held on February 21. The walk is being hosted by the University of California San Diego's Eating Disorders Program--the same folks who run a five-day intensive outpatient program for families getting started with family-based treatment for anorexia or bulimia.

Sign up online to sponsor one or more walkers on UCSD's team, which includes Walter Kaye, Roxanne Rockwell, and Bridget Whitlow. Go, team!

A word about civility

Hey folks--

It should be clear by now that I'm not going to post comments that are rude, spiteful, mean, or abusive. I make an effort to be positive and constructive in my posts and when I respond to comments. I hold you to the same standards, or I won't be allowing your comments.

We don't have to agree. We do have to have a civil dialogue.

Frankly, my college writing students are far better at the whole constructive criticism thing than some of my anonymous commenters.

And you know what? It's hurtful. And hurt just breeds hurt.

So please, do yourself a favor, and either grow up or go comment on someone else's blog.

The Woman at the Y, Part 3

She was there again, the woman who comes to the Y sometimes. The woman who is so painfully thin I can see the shape of her femurs through several layers of clothes. The woman whose gaze is inward, whose face has the haunted look I recognize.

This time I tried to engage her before class--to reach out. I said hello. She looked at me and turned away. I haven't seen her talk to anyone, so maybe this wasn't surprising.

Usually she stays at the back of the class, but not today. Today she took a spot front and center, right behind the instructor and in front of the mirror. The harder the workout got, the more broadly she smiled at herself in the mirror. The more she smiled, the more sick I felt.

In the end I had to leave. I grabbed my coat in the middle of a song and ran out of the room, into a bathroom, where I cried and cried. I can't celebrate the joy of moving to music I love when I'm looking at her and imagining how many calories she's burning, how little she eats. When I know that she looks in the mirror and sees something completely different from what I see.

I don't know what to do, truly.

NAAFA takes on Michelle Obama's crusade against childhood obesity

I wouldn't normally repost a press release. But this one from the National Association to Advance Fat Acceptance is so well-researched and concisely effective that I can't resist.

Repeat after me, everyone: Shame is not a health-care strategy.

Enjoy.

NAAFA Challenges the First Lady

For Immediate Release
January 29, 2010

Oakland, CA – First Lady Michele Obama has recently announced her intention to focus on childhood obesity prevention. NAAFA encourages the First Lady to consider all the research before taking action and supporting any program that may do more harm than good.

Mrs. Obama, please explore and consider the following:

• When important figures such as parents, teachers and peers in children's social environment endorse a preference for thinness and place an importance on weight control, this can contribute to body dissatisfaction, dieting, low self-esteem and weight bias among children and adolescents (Davison & Birch, 2001; Davison & Birch, 2004; Dohnt & Tiggemann, 2006; Smolak, Levine, & Schermer, 1999).

• The stigmatization of large children has increased by 40% over the last 30 years (Latner & Stunkard, 2003).

• Many drugs presently being prescribed to children cause weight gain. There was a 40 fold increase in bi-polar diagnoses in children between 1994 and 2003. 90.6% of youth received a psychotropic medication during bipolar disorder visits. For many, mood stabilizers, antipsychotics, and antidepressants were also prescribed. (Arch Gen Psychiatr,. 2007)

• Prescribing dieting is, in effect, prescribing weight cycling, and many people will be fatter in the long run (Mann, 2007).

• Weight-control practices among young people reliably predict greater weight gain, regardless of baseline weight, than that of adolescents who do not engage in such practices (Neumark-Sztainer et al., 2006).

• Based on results from a population-based, longitudinal study with 2,500 teens, Neumark-Sztainer and colleagues at the University of Minnesota (2006) concluded that to prevent obesity and eating disorders, the focus needs to be on health much more than weight. The more weight per se is talked about, the more likely teens are to adopt dangerous dieting behaviors.

• A 2006 study from UCLA suggests our media and cultural obsession with achieving a certain weight does little or no good and may actually undermine motivation to adopt exercise and other healthy lifestyle habits.

• The National Center for Health Statistics, part of the Centers for Disease Control and Prevention indicated in 2008 that childhood obesity has leveled off.

NAAFA urges the First Lady to:

• Partner with us and our many resources in the scientific and healthcare communities to examine this issue. Fat children are already the targets of merciless bullying. NAAFA urges Mrs. Obama not to support any programs that would create a pervasive bias against fat children.

• Consider Guidelines for Childhood Obesity Prevention Programs found at: http://www.aedweb.org/media/Guidelines.cfm Childhood School Plans at http://www.healthyweight.net/schools.htm and Guidelines for Children at http://www.healthyweight.net/children.htm

• Support the Health at Every Size (HAES) tenets which state that healthy habits are good for EVERYONE, no matter what their size. Eat healthy, nutritious foods and enjoy occasional treats. Pay attention to your natural hunger and satiety cues. Move your body in ways that feel good rather than exercise focused solely on weight loss.

"Obesity has a strong genetic component that is expressed in environments that foster sedentary activity and eating an energy dense diet", stated Joanne Ikeda, Nutritionist Emeritus, University of California Berkeley, "Therefore, we encourage First Lady Michelle Obama to promote environmental changes in school settings that support enjoyable physical activity and consumption of a wide variety of nutritious, appetizing foods."

This issue is about the critical need to create environments in which children and adolescents do not feel shame or guilt about their bodies but, rather, are motivated to enjoy healthful eating and active living habits regardless of their body size or shape.

Founded in 1969, NAAFA is a non-profit human rights organization dedicated to improving the quality of life for fat people. NAAFA works to eliminate discrimination based on body size and provide fat people with the tools for self-empowerment through public education, advocacy, and member support.

On the web:
http://www.naafa.org

News flash: A little "extra" weight can be a good thing

Especially if you're over 70, say researchers at the Western Australian Center for Health and Aging.

A recent study shows that normal-weight and obese patients over 70 had slightly higher levels of mortality than those whose BMIs put them into the overweight category--BMIs of 25 to 29.

In an article in the Journal of the American Geriatrics Society, the researchers said, "These results lend further credence to claims that the body mass index [BMI] thresholds for overweight and obese are overly restrictive for older people."

Makes sense to me--that "extra weight" is what Ellyn Satter describes as "nutritional resources." Food is fuel, folks. Your body needs food not just to power itself but to fuel resilience, especially as we get older.

Now I want to see them study this same notion in 60-year-olds. I'm curious about what the results might show.

Chicago conference! April 26!

If you're in the Chicago vicinity (or even if you're not), please join Maudsley Parents for a day-long conference featuring some of the smartest and most articulate researchers in the field of eating disorders.

Our speakers include Dr. Walter Kaye, director of the University of California San Diego's Eating Disorders Program, and Dr. Daniel Le Grange, director of the University of Chicago's Eating Disorders Program. They're two of my all-time favorite experts, and they'll have some exciting new research results to share. We'll also have a panel of parents who will share their experiences using Family-Based Treatment (FBT) to help their children recover from eating disorders.

Register here before Feb. 28 and the fee is only $40. After March 1, the fee is $50.

I'll be there--I hope to see you!

The decade's worst photoshopping, and it's all done on women

The first decade of the 21st century was apparently the decade of Photoshop. Here, Newsweek magazine takes us through some of the decade's most egregious Photoshopping as applied to women's bodies.

We know this kind of overzealous retouching happens, of course, but seeing it drives home the point: When it comes to women's bodies, our culture is seriously fucked up.

Because really, who is the Photoshopping for? Do men really prefer women who look like praying mantises to women with, well, normal proportions? Or is it women who judge one another (and ourselves) so harshly that we demand an unattainable beauty ideal for ourselves, damn it?

Well, neither. You know who loves images like this? Advertisers. Media advertisers. They're the ones trafficking in fantasies. And what is an unattainable beauty idea if not a fantasy?

So how can we respond? We can boycott the offending advertisers. We can consciously look at slideshows like this, reminding ourselves that the images on the left are not any less beautiful than the ones on the right that have been retouched. Au contraire--in pretty much every case I find the unretouched image far more powerful and moving than the ridiculously overdone fantasy on the right.


**Thanks to Christen Brandt for finding the slideshow!

Let's hear it for Gabby Sidibe's designer

. . . who has the guts to articulate, in an interview with the Washington Post, the sad truth about the fashion business: It exists not to serve women but to use them. As Megan Carpentier over at Jezebel writes, "If a designer wants to design a pair of formal, satin shorts with pleats and pockets because for some godforsaken reason he thinks that's cool, then he's got to find a rail-thin model to wear it, or else his design is going to look as ugly and unflattering as it actually is. If he wants to design clothes for women to wear, then he might actually be forced to take into account the women who will be wearing them."

And thanks to Carpentier for pointing out some of the cognitive dissonance in the story. Which is unsurprising. We as a society are so screwed up on the subjects of weight and health, it's a wonder we don't all burst into tears every time we walk into a clothing store.

OT: RIP Kate McGarrigle

Why I believe in fat activism

Scene: Meeting of my university's diversity committee (of which I am a member), where we have been planning a day-long diversity workshop for our faculty. Much conversation over who will be resistant to such a workshop, who is resistant to the idea of diversity in education in general. Much conversation in general over issues of cultural competence, etc.

The conversation turns to the current crisis in Haiti.

Professor Y: Some of the coverage on this has been unbelievably racist.

General agreement around the table.

Professor Z: Pat Robertson is talking about those "colored" people making a pact with the devil. And Rush Limbaugh, too. It's unbelievably offensive.

Professor X: Yeah, especially for a fat white guy like him!

Beat.

Me: Did you say "fat white guy"?

Professor X: (to his credit) I just caught myself.

Cut.

At the Y

She was there again this morning, in the vigorous Zumba class I take most Sunday mornings. I love this class because it's fun--exercising to blaring Latin music, following an instructor who shows rather than teaches the moves. I also love it because there's such a wide variety of ages and body types represented, from the hunched-over 70-something woman to 10-year-olds with their mothers. The women in the class--and we are women, although men are welcome--range from thin to fat. Each of us moves to the best of her ability. There are good dancers and bad dancers in the class, and it's all OK.

There are plenty of thin women in the class, but the woman who turned up this morning--second time I've seen her in class--is far thinner than anyone else. Her close-fitting black leggings reveal the shape of her femurs where they meet her jutting hipbones. Her arms look like they might snap at any moment. Her face has a look I've come to recognize, a driven look that also conveys flatness, a certain kind of despair.

You can't tell whether someone has an eating disorder from looking. But I'd bet a year's salary that this woman has anorexia.

Last time she turned up in the class, I went out to the front desk afterward and asked if the Y had a policy about people with eating disorders or whose health was compromised in other ways taking vigorous exercise classes. Shockingly, they do not. I explained my concerns to the woman at the desk, saying I was afraid this ill woman might collapse in class. Or worse. I hoped I wouldn't see her again.

But there she was this morning. In a sweltering room, she wore leggings and a sweatshirt zipped to her chin. I watched her exercise in the mirror; she didn't know most of the steps, being new to the class, but she threw herself into the dancing with determined force. She was burning calories. I couldn't tell if she was having fun. Most women in the class smile through much of it, but this woman's expression never changed.

I'd thought at lot about her since the last time I saw her in class, and decided I would try to talk to her after class, befriend her, get to know her. Only this time, like last time, she ducked out of class before the end. I glimpsed her on one of the elliptical machines on my way out, and wondered how many hours a day she spents at the Y.

I was struck recently by a quote in this film, made by documentary filmmaker Hope Hall about her mother, who's struggled with anorexia and bulimia for many years. The film includes a voiceover phone call between Hope and her mother, where her mother says, "Through all my growing up, through all my marriage, I was always trying to measure up, trying to be somebody else. And all of a sudden, you said, 'I just love you. I don't need you to be well.'"

I think about the woman at the Y, and am torn by what I wish for her. I hope she people in her life who just love her. But I also wish that she, and everyone with an eating disorder, had people in their lives who could help them get well. Who could help them out of the private hell of anorexia and bulimia and into a life filled with something besides starving and binging and suffering.

I hope the woman does not come back to class, because, selfishly, I am uncomfortable seeing her there. In her gaunt face I see the face of my daughter, Kitty, at her sickest. I imagine Kitty at age 40, living this kind of hell, and I feel sick.

I wish I knew what I could do to help.

A difficult childhood = health risks?

I know from my own experience that childhood traumas can turn into psychological issues in adulthood. Now new results from a long-term study in California suggest that certain kinds of childhood traumas can translate into other kinds of health risks.

As reported in Time magazine, researchers at Kaiser Permanente have found correlations between certain kinds of traumatic events in childhood--sexual, physical, and emotional abuse--and elevated risks of heart attack, stroke, depression, emphysema, and, yes, my favorite bugaboo, obesity.

Here's a quote from the Time story:

"For the past several decades, the ACE study has recorded reports of negative childhood experiences in more than 17,000 patients. Adverse experiences include ongoing child neglect, living with one or no biological parent, having a mentally ill, incarcerated or drug-addicted parent, witnessing domestic violence, and sexual, physical or emotional abuse. . . . Compared with a person with no adverse childhood experiences, or ACEs, a person with four or more has almost double the risk of obesity. Having four or more ACEs more than doubles the risk of heart attack and stroke, and nearly quadruples the risk of emphysema. The risk for depression is more than quadrupled. Although many of these outcomes could reflect the influences of genes and other environmental influences — beyond those occurring in childhood — the tight relationship between increasing ACE numbers and increasing health risks makes the role of child trauma clear."

Some of these correlations seem straightforward, like the one between ACEs and emphysema, which can be explained at least in part by higher levels of smoking-as-self-medication. But this study takes the correlation a step further:

"Early adverse experience can disrupt the body's metabolic systems," says Dr. Jack Shonkoff, director of Harvard's Center for the Developing Child. "One of the cornerstones of biology is that our body's systems when they are young are reading the environment and establishing patterns to be maximally adaptive." Researchers also posit that high levels of stress hormones caused by ACEs can wear down the body over time. A temporary spike in blood pressure in response to a stressful event may be useful to power an adaptive fight-or-flight response, but over the long term constant high blood pressure could raise a person's risk for heart attack and stroke. Studies have also found that consistently elevated levels of stress hormones, like cortisol, can lead to permanent damage in certain brain regions linked to depression.

Even more interesting, they suggest that such stress-induced physiological changes can be passed down through the generations through epigenetics, changes in the traits expressed by genes that don't come from mutations in DNA.

Fascinating stuff. What it suggests to me is yet another refutation of Cartesian dualism. What we think and feel and experience may shape us in more ways than we know.

What do you think?