Greta Christina's fat positive manifesto

[ciphergoth]

I froze the discussion here because I thought it deserved a top-level post of its own, rather than being under a general discussion of Greta Christina. A few weeks ago she posted a very interesting series of articles on the fat-positive movement and her own beliefs; I'd be very interested to read more about what people think of them.

"I was frankly shocked at how callous most of the fat-positive advocates were about my bad knee. I was shocked at how quick they were to ignore or dismiss it. They were passionately concerned about the quality of life I might lose if I counted calories or stopped eating chocolate bars every day. But when it came to the quality of life I might lose if I could no longer dance, climb hills, climb stairs, take long walks, walk at all? Eh. Whatever. I should try exercise or physical therapy or something. Oh, I'd tried those things already? Well, whatever."

• The Fat-Positive Diet
• The Fat-Positive Skeptic
• An Open Letter to the Fat-Positive Movement

Comments

[djm4]

Good idea, and it deserves a better (and more measured) response than the somewhat snarky one I gave on the previous post, but I don't honestly know when I'll find time to write one. Not in the next couple of weeks, certainly.

[djm4]

Actually, who am I kidding? I'll never have the time, and am officially bowing out of this debate.

[wildeabandon.livejournal.com]

I'm largely in agreement. The vast majority of what the fat-positive movement stands for should be uncontroversial, but to quote your response to the third post:

"I agree that unless you are an expert - and by expert, I mean on the level where your research is published in peer-reviewed journals - you are crazy to bet against the scientific consensus."

I haven't done enough reading of the literature to be confident in what the scientific consensus is, and to what extent it is scare-stories in the media, but I've certainly seen more papers arguing that there is a negative correlation link between weight (above a certain level, obviously) and a variety of health measures than I've seen arguing the opposite.

[ciphergoth.livejournal.com]

I'd be willing to take a bet on what answer I'd get if we asked the head of a randomly chosen University medical department - and if I'm wrong about this I'd like to know very much.

[valkyriekaren.livejournal.com]

Certainly the learning objectives here at St George's are keyed towards an understanding of BMI and the importance of lifestyle changes (including activity level, dietary restrictions and weight loss as appropriate) in controlling conditions such as high blood pressure, high cholesterol and heart disease.

(I still think BMI is unreliable and shouldn't be the be-all and end-all, and that the lines for 'healthy' and 'overweight' are drawn in completely the wrong places. But that doesn't mean it's not an OK place to start when looking at overall physical health.)

[wildeabandon.livejournal.com]

One thing that I have a suspicion is supported by the science, but is a long way from permeating through to the popular consensus, including medics, is the fact that diets usually don't work.

[lizw.livejournal.com]

In this particular case, I think there are strong reasons to bet against the scientific consensus, starting with the fact that almost all of the science in question is of appallingly poor quality and skewed by a combination of politics and big money. I'd recommend picking out some specific studies and looking to see whether junkfoodscience has commented on them, or reading her obesity paradox series.

[ciphergoth.livejournal.com]

I'd recommend picking out some specific studies and looking to see whether [info]junkfoodscience has commented on them

This is a good recommendation. I can't find anything on any of the studies referenced here on junkfoodscience, though that's not to say they're not discussed.

Edit: I note they have a post specifically about junkfoodscience.

Edit: and she links with approval to global warming denialist Steven Milloy's junkscience.com. Top link on her list of recommended links. Last is noted nut Bjorn Lomborg. Um.

[purplerabbits.livejournal.com]

Hmm. I find "The Fat-Positive Diet" kinda depressing because it's so exactly where I was a few years ago, including the unintended boost you get from people telling you you look better, the mixed messages you get, the everything.

And I am now heavier than I have ever been. Which might mean I can't participate in a debate like this as objectively as I feel it deserves.

I think her Fat Positive Manifesto is *almost* right and that her depiction of the Fat Positive message she's been getting is neccessarily cherry picked and a reaction to a range of annoying comments she is bound to have recieved. I'm not sure any real person believes all of that, so it's in danger of being a bit of a straw man argument.

I wish I knew what to think about the science, I really do, but I don't know of *anyone* who is doing a balanced job on this.

[djm4]

I'm utterly in agreement with the paragraph you quote here, by the way, whatever else I might think.

[altamira16.livejournal.com]

I think that people shouldn't be mean to fat people just because they are fat, but I think the whole notion of a fat-positive movement really depressing.

[valkyriekaren.livejournal.com]

Can you explain in more detail why you find it depressing? I'm not sure I understand your position.

[altamira16.livejournal.com]

LJ used to have a very active pro-ana group. I find a fat-positive movement depressing for the same reason that I find the pro-ana group depressing. Specifically, these groups are allowing people who have an unhealthy relationship with food to learn even more unhealthy behaviors and preventing them to confront the root cause of the issue. This is not saying that all fat people have issues with food, but I think that a significant portion of them probably do.

[djpsyche.livejournal.com]

But thinking, "I can never have another donut again as long as I live" would make this intolerable. Thinking, "I can have a donut today if I have a light dinner" makes this do-able.

And this is the nutshell of my argument of why Quitting Smoking Is Harder Than Dieting.

[purplerabbits.livejournal.com]

I don't think I agree, because dieting, or even just healthy eating, isn't a case of saying "I can never have another donut again as long as I live" it's saying "I can never eat without having to think about it again". Just giving something up cold can be way easier.

[http://users.livejournal.com/_lj_sucks_/]

I was diagnosed as celiac, and on a gluten-free diet for the first 15 years of my life. I didn't grow up being able to eat things without thinking about it first, so maybe that's why I didn't find it an insurmountable challenge to carry on doing so.

There's a parallel here with people who say "Oh my god, (antidepressant|diabetes) medication, I could never cope with having to take a drug every day for the rest of my life"--again, as a sickly child with hellish allergies, I grew up needing some kind of medication every day, so the idea of my life or sanity depending on a daily dose of pharmaceuticals just isn't a big deal for me.

Whether quitting smoking or dieting is easier probably depends on the personality of the individual. I believe that the research shows pretty clearly that some people have addictive personalities. Looking at it from the opposite side, I have amazing reserves of stubbornness compared to most people. So for me, quitting smoking would probably be easier.

On the other hand, there are people who find evaluating complex decisions (such as navigating the maze of options in a restaurant or supermarket) to be challenging and stressful. Again, there's science to back this up; even some large scale studies showing health changes in the former East Germany, for example. For those people, the temptation to give up on the complex multi-dimensional decisions and eat what appeals to their taste buds is probably as appealing as some find the temptation to suck on another cancer stick.

[ceb.livejournal.com]

I disagree. Firstly, a lot of eating is habit, and once you're over the effort of breaking a habit and forming a new, healthier one then you're back to not having to think about it all the time. Secondly, changing eating habits also changes the way things taste; if you avoid eating salty things (say) for a while, when you go back to them you may well find they're no longer so pleasant to eat.

[ciphergoth.livejournal.com]

Interesting. Ainslie's Breakdown of Will makes exactly the opposite argument - that dieting is harder than quitting smoking exactly because it's easier to make a clear and simple rule and stick to it than navigate the maze of making choices that keep total calorie intake at about the right amount.

[lizw.livejournal.com]

Okay, some quick comments because we're ridiculously busy at work and that's all I have time for:

The Fat-Positive Diet uses the wrong definition of success, in my view. A 10% one-year "success" rate is already appalling - a drug or surgical intervention with this rate of success and the same physical mental health side effects as dieting would not be licensed - but the rate drops to 2% after another year. Statistics beyond that don't exist, because it's not even possible to recruit a large enough pool of "successful" dieters to do that study. My source for this is Paul Campos in The Obesity Myth.

The Fat-Positive Skeptic and the Open Letter are wrong about the science, and for that I repeat my suggestion to wildeabandon earlier in this thread. I would also add that even if I am wrong (and so is Paul Campos, and so is Sandy Swarcz) on (a) whether or not being fat is unhealthy and (b) whether or not diets "work", there is still AFAIK not a shred of evidence as to (c) whether someone for whom a diet has "worked" thereby acquires the same health benefits that someone who maintains the same weight, BMI etc without dieting ex hypothesi enjoys (and, given the problem with recruiting "successful" dieters, it is difficult to see any such evidence emerging any time soon.)

I do feel sympathy for her knee pain, having had similar problems myself in the past (at a much lower weight than I am now), and she is of course entitled to take whatever gambles she wishes to try to resolve it - just as she is entitled to try homeopathy, reiki, animal sacrifice or anything else that does no harm to anyone else. Perhaps the sense of taking charge of the problem will even produce a placebo effect that will do her some good, and I'm all in favour of that where medicine can't come up with anything better. But I believe it will be just that - a placebo, and one bought at the price of considerably more health risks than drinking water that may or may not have come into contact with a minuscule drop of herbal extract at some point in its history.

Edited for clarification of my view on placebos.

[seph-hazard.livejournal.com]

I am 100% on your side here, really, and grumbled about the posts in question when I first saw them a while back, but I am tempted to suspect that with things like this particular sort of knee pain losing weight might help a bit because of, well, gravity. Lighter body = less physical pressure opon knee = possibly less pain.

[thekumquat.livejournal.com]

I think one thing that both the fat-positive and anti-fat sides are both guilty of is assuming there is a weight and diet for anyone that will enable them to stay in optimum health and not in itself cause health problems.

I think this is most unlikely, given that our bodies are bodge jobs resulting from evolution. Which means most of us a lot of the time really should be thinking about which potential side effects of our diet or weight matter most to us, and remembering that there *will* be some.

Coming back to this after roughly a year.

[grendelkhan.livejournal.com]

Necromantic fascination with resurrecting dead threads aside, having recently reread the comments here and GC's March 2010 update on her diet and exercise regime, I have a question or two.

I can't see find the bit about diets having a 90% one-year and 98% two-year failure rate; could you cite that in the book more specifically? Google Book Search is being less helpful than I'd like. Does that include crash diets?

I haven't read The Obesity Myth (though it's now on my shortlist), but GC's update mentioned the National Weight Control Registry, a longitudinal study which takes participants starting from the one-year point, which currently tracks around five thousand participants. Here's a list of their publications. (http://www.nwcr.ws/Research/published%20research.htm) This is especially interesting because Campos does mention the NWCR (page 120 of the copy on Google Book Search). NWCR has at least one study on the exercise habits of always-thin and previously-fat people, but none that I see on the secondary health risks we're told are consequential to obesity.

And while I know that anecdotes are terrible for proving a point, they certainly can disprove one. If it's unspeakably rare to find people who have kept off thirty pounds (NWCR's standard) from their peak weight for more than two years, then why on earth do I count at least two among my immediate family and in-laws?

The overarching problem, I suppose, as has been noted elsewhere, is that there's no such thing as descriptive information here; it's all implicitly prescriptive. Like GC keeps saying, there's a particular confluence of factors that led her to count this as a net good decision, but without some of them--free time and privilege to get to the gym, supportive partner, etc.--it would have been a bad idea, and, despite how it'll inevitably be seen, the moral isn't "all you fat people are just too lazy to diet".

[wildeabandon.livejournal.com]

One thing that came to mind yesterday is that the question "is fat bad for your health" and the question "is fat worse for your health than dieting" are two very different questions, but both the anti-fat and fat-postive sides tend to conflate the two.

[ciphergoth.livejournal.com]

Yes, I'm seeing this a lot.

[palmer1984.livejournal.com]

OMG THIS.