[Never Say Diet] Yes, You Can Be Fat and Healthy

Today’s Never Say Diet post is about a really exciting new study which finds that about 20 percent of obese people are perfectly healthy — as in, no clogged arteries, no OMIGODDeathFat (as Ragen likes to call it). Which is a big enough percentage in my book to end the debate and officially say no, you cannot diagnose someone’s health based on their size, Body Mass Index, or number on a scale.

Well you can. But you have a 1 in 5 chance of being wrong.

Which means we need to continue the discussion that we have on here all the time about how we can separate weight from our understanding of health so that when we talk about wanting to be healthy, we mean sustaining healthy lifestyle habits (eating well, exercising more, getting enough sleep, managing stress). And when we talk about wanting to lose weight, we’re talking about aesthetics and changing our bodies to meet a beauty standard.

And yes, there is overlap — a healthy lifestyle might result in weight loss or weight stabilization, and if you go about losing weight in a way that doesn’t wreak havoc on your health (and I hope you would — because harming your health to meet a beauty standard is a dicey business!), you’ll probably adopt some healthier lifestyle habits at the same time.

Another similarity between pursuing health and pursuing weight loss is that they can both be wicked hard to sustain day to day if you only have vague future goals (like “I don’t want to get cancer” or “I must be thin for my vacation six months from now”) as motivation. Neither addresses your need for a cookie in the here and now, which means we end up feeling like failures when we eat the cookie instead of sticking to whichever vague, not entirely realistic or helpful goal we’ve decided to pin all of our self-worth on achieving.

But really, health and size aesthetics are two different, complex, multifaceted issues with a few points of intersection.

Not synonymous.

Not simplistic.

For more on the science behind this, check out Never Say Diet. (Oh but first! Apologies in advance — I did not choose the photo and I think y’all will understand why I didn’t repost it here the way I usually do.)

And I also want to hear what you think: How do you define health for yourself? Is weight (or size or appearance) a part of that definition or are you working on separating that out into its own little box? Which, even having read the research, is easier said than done, I know… those darn cultural messages go deep.

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16 Comments

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16 responses to “[Never Say Diet] Yes, You Can Be Fat and Healthy

  1. That photo is all wrong- thank you for not reposting it!

    • I know. It’s objectifying and has nothing to do with the point of the post. Headless person wearing granny panties with a tape measure? What does this have to do with broadening our definition of health? Argh.

      (I have shared my thoughts on the subject with the PTB, worry not.)

      • I’d really like to know the circumstances under which that picture was taken. What was the conversation with the model: “Oh, don’t worry about your makeup, hon — it won’t be in the photo anyway!”

  2. Health for me will be a lifetime process in which I try to listen to my body think about what it needs or wants at any given moment, and why. That goes for sleep, vegetables, yoga, water, fresh air, kickboxing, cookies, sunlight, a glass of wine, a cat nap… even sex. Obviously, I can’t give it the perfect cocktail of all of those things at any given moment, but trying to think about why I feel the need for each one is educational.

    In terms of straight fitness, for me it’s about progress. Being able to do things better than before. “Better” could many many things… holding crow longer, getting deeper into a stretch, running two extra blocks, etc.

  3. Frustrated

    “But this research does say one thing loud and clear: “I can’t tell you how healthy someone is if you tell me height or weight on a scale,””
    This, this is important. I was recently denied help from my doctor about an eating disorder because I am of a healthy size and weight. The other indicators of poor health resulting from my diet – skin discolourations, excessive paleness, fragile easily bruised skin and wounds taking forever to heal – were ignored in favour of my ‘healthy’ BMI. And psychologically, I am still terrified to the death of the vast majority of foods.
    BMI=/=ultimate health indicator is so frakkin important. I wish people could see that. The bias works in both ways – you can be discriminated for being overweight and for being a healthy weight.

    • Frustrated: I am so frustrated for you!! And appalled with that doctor. And really hoping you can find A) a much better doctor and B) the help you need. Seriously, excellent, excellent point. Good luck. xo

    • Sophie

      I’m a survivor of ED-NOS and bulimia nervosa (see my post down the page), so your post does not surprise me – but it disturbs me deeply. Go to another doctor and go as soon as you can. If the next doctor doesn’t give you a referral to a psych, then keep trying others until you find someone who will believe you. You may find a more sympathetic doc at a women’s health centre, it’s worth a try.
      If worst comes to worst, lie to your GP and tell them that you are purging. They are more likely to take this seriously than the earlier signs of an ED. Once you see the psych you should tell them the truth of course to get the proper treatment, but no reputable psych would dismiss your current problems.
      Best of luck, and remember to never give up hope. When it gets really tough, just keep working on your recovery, and one day you will find yourself not thinking about food at all. It’s a beautiful day when you first feel that 🙂

  4. How do you define health for yourself? Is weight (or size or appearance) a part of that definition or are you working on separating that out into its own little box?

    “Health” for me is a complicated concept. It includes daily choices under my control, yes. But it also includes chronic illnesses (endometriosis and Crohn’s) of unknown origin. And it includes psychological health (including PTSD, past assault/abuse, and disordered eating patterns) in addition to physical health. How all those pieces fit together — if I can exercise, if exercise is healthy for me today, if the painkillers are damaging my body more than the pain, if I’m absorbing enough nutrients, if I’m eating too many calories, if I can let go of the food guilt, if I should eat that cake, if the smell of dark chocolate is the only thing keeping me from dissociating, etc. — is intricate and changing.

    In my logical mind, I’ve separated weight and size and appearance out from health. I’ve been in that place where I was consuming too few calories and exercising too much (maybe obsessively); that is the only place in my adult life where I’ve been down to a “normal” weight. I’ve been in that place where my body was complaining because I wasn’t providing the support for it to do what I asked of it. And now? I’m probably 9 BMI points higher; my percent body fat has increased a bit as well. But I’m at a place where my body is — most days, endo pain and nerve damage aside — happy to perform as I ask it. My fat body is healthier than my thin body ever was.

    But there’s also the illogical mind that doesn’t do so well with accepting my larger shape. This is the part of my mind that remembers my mom’s voice declaring some foods “good” and some “bad” and giving me disapproving looks over any desserts or seconds. It’s the part that remembers my ex’s declaration, “No fat chicks!” — both as we were considering polyamory and as my body was becoming larger. It’s the part of my brain that remembers no fewer than a dozen doctors telling me that my period pain (before endo diagnosis) would go away if I just lost weight. Even as I know these internal voices don’t serve my emotional health, the most I can do is ignore them. I can’t make them go away.

  5. Maggie

    Health for me means feeling physically good most of the time. Not constant stomach aches and headaches and general not feeling well.

  6. Jennie

    I love you so much. And this kind of post is exactly why.

    Health, for me, means feeling happy – and that includes not feeling winded after bringing in groceries or feeling gross because I ate something that disagreed with me. Currently I am having LOTS of stomach trouble that we are working on identifying, so that last one comes and goes. But I would like to get healthier – add more stamina, mostly. I was skinny in my high school/college years, and had a sudden gain due to medication that I am still trying to lose. But I don’t think that I would have to be “perfectly shaped” again to be happy – just “normal” would feel great to me as I grow to like myself as more than a body. Working on those messages!

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  8. Sophie

    As a survivor of bulimia nervosa, this article raises some serious concerns for me. I don’t want to tell anyone else how they should live their life, I just want to tell you about my experience.
    Before I was bulimic I was ED-NOS (eating disorder not otherwise specified). I used to binge eat and I was obese as a result. This made me deeply unhappy and it was a very damaging behaviour for me, at this time I was just as desperately unhappy as when I was bulimic.
    One thing which allowed my binge eating to become so extreme is that no-one around me would accept that it was a problem. I knew it wasn’t ok but everyone told me that I was just naturally bigger and talked about the beauty myth if I mentioned that I wanted to lose weight. For me, being obese was a direct result of being depressed, and I wish someone had recognised that and encouraged me to get help.
    When I tried to take control of my weight issues I did it alone. I read books and followed correct medical advice, but I didn’t understand that I needed to get psychiatric help as well as changing my eating habits. For that reason, I lost a lot of weight but eventually developed bulimia nervosa. I tried to do the healthy thing but without proper support I simply replaced one eating disorder with another.
    It took many years and several admissions to psychiatric wards for me to recover. I’m happy to say that I’ve been fully recovered for a few years now, but it was a long struggle. Many sufferers don’t make it out alive.
    For the first time in my life I have a healthy relationship with food: I can recognise when I’m actually hungry and stop eating when I’m full; I don’t think about food except when I’m eating it; I enjoy the food I eat; I never feel guilty about eating; and my diet is generally well-balanced, which includes junk foods. What I discovered from this is that I’m not naturally big at all. My weight has settled at around 55kg (I’m 5’1) and doesn’t fluctuate anymore, not even when I’m very stressed. This weight is clearly what is natural for my body, rather than the 78kg or the 47kg I once was. I’m fairly slim but not skinny. I have cellulite like most women. I don’t and will never look like a model – but I don’t care. This is my natural weight and I consider myself beautiful.
    Now I’m not saying that all people who fall into the category of overweight or obese have deep emotional issues – that’s simply not true. Not everyone who struggles with weight has an eating disorder, and not everyone outside of the ‘healthy’ BMI struggles with their weight. Nevertheless, I think it’s vital to recognise when someone DOES have a problem. Mental illness is very tough to recover from and sufferers have the best possible chance if their disorder is caught early.

    • Hi Sophie,

      Thank you so much for sharing your story — you make so many good points. It is important to note that just like we can’t assume that every fat person is a compulsive overeater and every skinny person is anorexic, we can’t assume that every person we see is 100% healthy either. Body size can be a sign of other problems. So I think, in a way, we’re making the same case: That you simply can’t tell a person’s health by looking at them. In your case, the extra weight was a sign of your mental illness, but as you note, that wouldn’t be the case for every overweight person. And as Frustrated’s story illustrates, you can be struggling with ED at a “healthy” weight.

      I’m not quite sure what the solution is — obviously, in your case, it didn’t help to have people tell you to accept your obesity because that got in the way of you getting help. But when weight can mean so many different things about a person’s health (in that it literally can mean everything or almost nothing!) I do think it’s problematic for those around us to use that as a barometer of our health. I wonder if someone had recognized your depression — which surely manifested in other symptoms along with the extra weight? — and encouraged you to deal with that, if that would have worked as a starting point? Because, as you say in your comment, dealing with the weight issue alone (i.e. changing eating habits) wasn’t enough. You had to first and foremost deal with the emotional issues that were the root problem. Weight/eating habits are just the symptoms.

      Obviously, the MOST important thing is here is that you got the help you needed and worked so hard to get where you are today in your recovery. I don’t even know you and I’m thrilled and proud for you. And again, so appreciate you sharing this perspective — it really got me thinking about all the many layers of these issues!

  9. Ahhh I replied super late, been so busy. Yea I think we do agree, we just have different perspectives on the issue.

    Thank you very much for your kind words 🙂 It’s all in the past for me so I’m totally comfortable discussing it now. ED sufferers need more positive stories of recovery anyway.

    You’re right, there were definitely other symptoms for me while I was ED-NOS – sleep problems, extreme mood swings, issues with maintaining relationships etc – all symptoms which are common with depression. Some of these symptoms I managed to hide from others and some I did not. Had I gained treatment for depression early on I almost certainly would have had an easier and quicker recovery. I probably would never have been bulimic. This is my fault for living in denial but also the fault of a society which treats mental illness as a secretive & shameful thing, something we should never talk about.

    What I think would be a great help would be a more general awareness of mental health in the community. People just don’t know. They don’t know how to recognise serious problems, and they certainly don’t know what to do to aid recovery. We need to educate people correctly and thoroughly, as well as making sure that psychiatric treatment is well funded. That’s a pretty big task though and I don’t know how to go about doing that.

    Another thing I would like to see is strict regulation of the diet industry. Fad diets are damaging and dangerous for everyone, and I think it should be illegal to promote any form of dieting which is not approved by the mainstream medical community. Mainstream medicine isn’t always right, but it’s a start. There is a lot of information out there which is a blatant lie, and a lot which is correct ONLY if tailored to individual needs and circumstances. Fad diets are often used by ED sufferers at great risk to their health, and can contribute to the development of disordered eating patterns into a full blown ED. They send the message that ED-NOS and binge eating is controllable if you just have enough willpower and buy the right products. This is simply not true. They set people up to fail then make them feel ashamed for it. I wish there was information readily available to let ED-NOS sufferers know that they have a treatable medical condition and direct them to places they can get help.

    I do support the fat acceptance movement now that I understand it, my concern is only that some ED-NOS sufferers will be misinterpret their intentions. Women like Ragen Chastain who say “health at any size” have a great message. Her blog challenged me to think outside my own experiences and I thank her for it. Without reading Dances With Fat I would still be utterly confused about FA and adamant that fat can’t be healthy. Those people who say “real women have curves” on the other hand, they worry me. I see that attitude as very dangerous in a multitude of ways.

    I will stop there as I started to launch into a long rant about what EDs are and what causes them (ie NOT the fashion industry!).. but it’s not really the time or place for that. Ooops.

    • Amen, sister! Right there with you on the need for more awareness about mental health issues, more regulation of the diet industry and the awesomeness of Ragen Chastein 🙂 Great, great point on the difference between the message “health at every size” and “real women have curves.” Totally not the same thing — and we all too frequently interchange them.

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