Fun Fact Friday: Fat Does Not Mean Unhealthy, Fat Means Fat

In this week's installment we're going to start the transition from LABELS to HEALTH. In the past two posts we've talked about the history of the BMI chart and the Great BMI Chart Scandal of 1998, but now it's time to focus on meaning and interpretation which is often glossed over by (some of) the medical community, the media, and just about everyone else. 

The popular conception is fat = high BMI = unhealthy = chronic health conditions. Everyone basically takes this to be a true correlation. But it is NOT. So let's break it down. 

What does a BMI chart measure? Oh that's right, a BMI chart is simply "a measure of body fat based on height and weight that applies to adult men and women." Otherwise stated, it's a mathematical formula that takes two numbers to create a new one. Sort of like a multiplication table! In fact look at a BMI chart without the standard "judgement" labels put on it:

 Now look at a standard multiplication table:

 

Hmm...strikingly similar no? The BMI chart is simply a table of numbers that hold no inherent value. It is derived from taking your weight in lbs divided by you height in inches multiplied by 703. Just like a multiplication table is taking one number times another number. Simple math. If only we stopped there...but of course, we don't.

We decide to place value and judgment on those numbers so that we have a chart that looks like this:

So following our analogy we should look at our multiplication tables like this:

And even further, let's start making judgments about our multiplication table:

•  4 times 20...you really should eat a cheeseburger. You're too small. Stop being so small. 
• 11 times 4...if you would just work a LITTLE bit harder you could be green ya know. Join the gym and you'll get there. You can do it. 
• 8 times 23...you're kind of gross. You should be ashamed of yourself. Really, how did you let yourself get that way?
• 5 times 25...you're just flat out disgusting. You should pretty much just go away. Forever. No one should ever multiply 5 times 25. Gross. 

Sounds completely ridiculous right??? SO WHY DO WE SAY THESE THINGS TO PEOPLE?  Why do we do simple arithmetic and then trash people's sense of self and worth by assigning a label to their bodies and then allow all of society to use these labels to degrade and demean? 

"BUT IT'S ABOUT PEOPLE'S HEALTH! I'm just helping them live a long, healthy life! They may not know that their FAT is KILLING them!"

Bullshit. 

Complete and utter bullshit. 

I've never seen a BMI chart that looks like this:

Know why? It doesn't exist! Because body fat is not a measure of health! BMI simply "measures" body fat and actually doesn't say anything about your health!You cannot use a BMI chart to predict someone's health or longevity of life. Because that's not what it measures. It measures fat. Only. Pure and simple. Furthermore, even researchers and doctors that believe in using the BMI chart for body shaming when pressed will tell you there are not CAUSAL studies that predict people's health and life longevity. There are some correlational studies, but even those are often flawed and often later retracted as BAD science. And just because something is correlated, it doesn't mean it that one causes the other. Fat does not cause poor health. Poor health habits, genetics, and other unknown factors cause poor health. Fat causes fat. We accept this in all other areas of science yet we suddenly are rendered stupid when it comes to talking about weight and health.

Are some people who are fat unhealthy? Of course. Are some "healthy weight" people also unhealthy? YES. Do all fat people have chronic diseases? No. Do some "healthy weight" people have chronic diseases? Yes. Do some fat people die young? Yes. Do "healthy weight" people also die young? Yes. 

BMI charts can't predict your health or how long you are going to live. 

So why do we keep using them? We'll investigate that next week

Fun Fact Friday: The Great BMI Scandal of 1998

So last week I introduced you to the history of the BMI table & its usage and left you with the cliffhanger of the Great BMI Scandal of 1998, so without further ado, let's delve into some mind-blowing controversy.

Another introduction needs to be made: The National Institutes of Health is an agency of the United States Department of Health and Human Services and is the primary agency of the United States government responsible for biomedical and health-related research. Let me reiterate an "agency of the US government" that is "responsible for biomedical and health-related research." You would think this agency would be good stewards of health research for the good of US society, yes? Well you'd be wrong in this case...

In 1998, a so-called "expert panel" convened by the NIH decided that the current BMI chart was "too generous" and that in an effort to "inspire" the nation to be "healthier" they must shift the BMI chart rating scales down so that more people realize they are fat and therefore know that they will DIE of the evil FAT. Now of course they didn't phrase it this way and made it seem like it was all about your health using a few (flawed and sometimes bogus) studies linking weight to health outcomes. The result quantified? 29 MILLION people woke up the next day now being considered overweight when the day before they were considered to be a healthy body weight. They didn't gain a pound, they didn't eat 47 cupcakes before bed, they didn't do anything besides do normal life things and all of a sudden woke up with a giant shaming label placed upon their bodies. That's some deep shit yo.

As we know, medical advances and new knowledge occur every day. So maybe this shift was warranted based on new scientific findings? WRONG. Let's take a look at two powerful FACTS:

Fact 1:

• The people in charge of making this shift at NIH perhaps maybe aren't your friends.

"Eight of the nine members of the National Institutes of Health task force on prevention and treatment of obesity have ties to the weight-loss industry, either as consultants to pharmaceutical companies, recipients of research money from them, or advisers to for-profit groups such as Weight Watchers."(Source)

Reaction:

• SAY WHAT?!?! You mean people who stand to gain money (probably LOTS of it) from more people thinking they are fat and going to die and therefore need to do anything to lose that weight are the ones responsible for telling you that you are fat?!?  Well isn't that fucking convenient...for them! Let's give 29 million people new complexes about their bodies! YAY! They're all gonna run out and join gyms, diet programs, and diet pills and we'll be rich! And people who have nothing wrong with them will suffer.

Fact 2:

• If this were really about HEALTH then we'd expect that to mean that people who are in the "normal" weight category to live the longest since long life = health in popular social terms. But guess what? Statistically speaking, the people who live the longest are people who measure in the "overweight" category of the BMI.

"Overall, people who were overweight but not obese were 6% less likely to die during the average study period than normal-weight people. That advantage held among both men and women, and did not appear to vary by age, smoking status, or region of the world." (Source)

Reaction:

•  HOLD UP. I thought this was about health? I thought we wanted people to live long healthy lives? Now you're telling me that I can live longer if I am actually NOT following your advice to be "normal" and instead choose to be the evil "overweight?" Huh. What's a fat lady to do? Follow your "expert" advice and possibly not live to my fullest longevity or be stigmatized by the medical community and therefore the rest of society in the hopes I'll live the longest life possible? That's a fucked up choice to have to make. Now there are alllll sorts of apologists who are quick to explain why this data isn't GOOD data and why it may means all sorts of other things other than the NIH panel is a bunch of greedy liars, but I'd like to point out that the same critical eye isn't given to all the studies THEY used to convince of this farce in the first damn place. It's hypocritical and wrong and it's causing a lot of harm to a lot of people. 

Conclusion for today's Fun Fact Friday: don't believe the hype. Especially when the hype was created by people who stand to profit from you thinking there is something wrong with you when evidence to the contrary actually says something different.

Next week we'll turn this debate around and start to think about the popular belief that fat = unhealthy = health conditions. Stay tuned!

Fun Fact Friday: BMI is a Joke

I decided if I had some hybrid activist-academic purpose to my writing I might actually DO more writing. SO my goal for the rest of the year is to bring you useful information that is readily available but OVERLOOKED by damn near everyone, but especially the media.

Right now I'm really, really energized about fat politics and activism, particularly because it has direct affects on my favorite topic which is radical body love. So for the next couple of weeks I'm going to do some deconstructing of our common "knowledge" about health, fatness, dieting, and body shame. This is nothing new. Lots of people have written about this before but many of my non-fat-activist-academic friends probably won't read 783 books, articles and blog posts I give them as references but they WILL (hopefully) read my words here on my blog. Also I'm only going to tell you the shit I find most compelling and in the order I feel like it makes most sense. Others may think other things are more important or may tell you things in a different way, but this is my blog so I'm going to do it my way. And now, with my signature voice and style, I'm about to break some shit down for you.

On today's menu...

The history of the modern day BMI chart! I know, titilating. But we have to start somewhere and before I can start blowing your mind with ideas that go contrary to everything you hear on the news every day about fat & health we have to start with a little history lesson. So pour yourself some coffee, water, alcohol, or any other beverage of your choice. Let's get started shall we?

BMI charts were first consistently linked to health outcomes in 1912 by life insurance companies (though they were called something else). Uh what? Over a hundred years old and thought up by insurance companies and not doctors? Need some perspective? Penicillin was discovered in 1928. We're using a health rating scheme that is pre-antibiotics. Sound ridiculous? It is. 

Here's a really boring article about how many ways we've measured fat over the past 100 years: http://ajcn.nutrition.org/content/72/5/1074.full. If you don't feel like reading it, cool. Let's just suffice it to say that the sheer number of ways it has been done and why is mind boggling. But also, for me, points out how flawed the system has always been, and continues to be.

The modern BMI chart was conceptualized and advocated for by Ancel Keys in 1972. NOTABLE in his publication is that he says straight up that: 

Populations differ from one another and populations change. Average values for weight and height for given age and sex for a given population do not necessarily apply to other populations or even to the same population at another time. Further, there is no present prospect of obtaining for any population true average values of weight for given height, age and sex. Certainly persons examined in connection with application for life insurance are far from being a random sample of the population.

Additionally he notes: 

In recent medical literature the so-called ‘ideal’ or ‘desirable’ body weight is often used as a basis of reference, the relative body weight then being expressed as percentages of values in the tables published by the Metropolitan Life Insurance Company [42]. Those tables take no account of age; in effect they simply list the average weights of insurance applicants of given sex and height at age about 25 [13-161. As noted elsewhere [43], the use of ideal or recommended weight confounds age and weight because on the average weight increases with age until the fifties while increase in height is over by the early twenties at the latest. The general trend to continue growth in weight may be undesirable but it has no relevance to the question of providing an objective description of relative body mass; it is scientifically indefensible to include value judgement in that description. The characterization of persons in terms of desirable weight percentage has resulted in attributing to ‘overweight’ some tendencies to ill health and death that are actually only related to age [43]. 

SO, the person who created the modern BMI scale is basically saying given the best measurement we can come up with for BODY FAT (not health!) it's still flawed and not a very good measure. Additionally it doesn't give us any information on whether that fat number is good, bad or otherwise. Veryyyyy interesting.

Stay tuned for next week when I tell you about the great BMI scandal of 1998. THRILLING SHIT MAN.

Something to chew on...

I've got some posts abrewin' about fat/weight/social commentary coming up, but until then and to start some thinking see this short message I got via the PostSecret community email this morning:

Hi Frank~

I attended your event in Kalamazoo, MI and I wanted to share a humbling story about that night. I was sitting fairly close and there was this overweight couple sitting in front of me that were hanging all over each other for most of the event. I was so distracted by all of their displays of affection I actually started to get annoyed. I think it was partly the displays themselves, and partly the fact that they were both on the heavy side and I was being judgmental.

When you asked for people to come up to the microphones, the woman stood up and was first in line. She said, "I have always had problems with confidence, but I have never felt more beautiful and confident than when I am with my husband." She then went back to her seat and sat beside him. He put his arm around here, whispered something in her ear and kissed her cheek.

Her secret resounded in my head, and at that moment, I wished I was her. I would trade my current 125 pound body with hers if it meant I could be as happy as she. I don`t know who she was and I will never see her again, but I want to thank her for teaching me a lesson that day.

Ponder that, and I'll get back to you soon.

Oooh, cool technology

I was flipping through some blogs and on the blog of a girl I went to high school with I saw this cool link to Prevention magazine's website and this neat-o techno app they have so I just had to try it.

The Weight Loss Simulator lets you put in your stats and change a little bit of appearance info in so you can see what your body looks like at current size and what it would look like at your goal weight. Of course it doesn't look exactly like me, but still cool and close enough to get an idea.

So here is the current, overweight me:
And here is me at my goal weight:
Ahhh...much better! I liked the visual representation. Maybe it will be a good motivator. It was fun to play with anyway!

Just call me Fat Fatty

Sad day for me. I went to the gyno for my annual check up yesterday and was reminded about how overweight I am about 85 times in 35 minutes. I mean, clearly I am aware that I need to lose weight, but I didn't expect to be so accosted by my gyno. I mean, it makes sense. I don't see my family practice physician on a regular basis...I probably haven't been to see him in about 2 years and the last time was just for renewing my migraine prescription. So she was just doing her job. I'm not mad at her, but I just didn't expect it and I would have been more mentally prepared if I had.

I've been meaning to renew my quest for personal health, and just haven't gotten serious about it. It's really hard for me to lose weight and I have to be pretty obsessive about it if I want to see serious change. I lost about 35 pounds about 4 years ago but I felt like I developed a very unhealthy relationship with food and working out and when I broke my foot (due to over zealous working out) I laid off it for a while. But I know that I need to lose weight and although it isn't harming my health at the moment, it will eventually so I need to get serious about it. I guess it comes down to either being unhealthy overall or having an unhealthy obsessive relationship with food and exercise. I think I'll choose the later. It seems the least damaging in the long run. Hopefully I can try and do it better this time, but we'll see.

And I'm totally kidding about Fat Fatty. I actually have a very positive self-image. I know I'm overweight and I need to work on it, but by no means is my self worth determined by the number of the scale. And I know that I don't need to be a stick woman and that Fat does not automatically equal unhealthy, but there is a difference between being pleasantly plump and obese. There is lots of research that supports that being very overweight is terrible for your health, particularly in the long run, so that is what my goal is based on. Getting down to a manageable weight that I feel comfortable with. I know I'll never be stick-stickly and I am definitely ok with that.

I had already scheduled a physical activity date with Alexis for Monday, so that was a good step forward anyway. I decided to call my mom and see if she wanted to join us. We swam for a little over 30 minutes. We decided that we'll swim on Mondays and Wednesdays, and I'll try and figure out some other activities the other days of the week (while appropriately scheduling rest for my body).

I also re-downloaded Diet & Exercise Assistant which is like an "app" for Palms (I just checked their website and apparently they have it for iphone and computers as well). It's a really good program that helps you track your calories and such. I bought it previously when I embarked on my last lifestyle change. I stopped using it when I realized that I was getting a little out of control with the whole thing. But I am gonna try it again and hopefully do a better job this time.

My goal is to try and lose 30 lbs. by the end of the year. That's 2 lbs. a week. It's a big goal but I figure if I don't challenge myself then I won't be as successful. I'd rather fail while working hard towards a big goal, then surpass a dumb goal. I can re-evaluate when needed. I'll be sure to keep you updated with my progress!