Yesterday, I wrote about being a fat-positive feminist who's losing weight. Today, I'm finishing up with a look at one of the trickiest and most loaded balancing acts in this struggle: being both fat-positive and a skeptic.
See, here's the thing. As you may or may not know, there is something of a pitched battle between feminist fat- positive advocates, and advocates of a skeptical, science- based view that fatness is medically harmful. (I'm not sure what to call the anti-fat-positives. Fat-negatives?) The fat-positives think the fat-negatives are hysterics who exaggerate the health risks of being fat; the fat-negatives think the fat-positives are denialists who dismiss those risks too easily. The fat-negatives point out the well- documented connection between being fat and a whole host of health problems; the fat-positives point out that many of these health risks significantly diminish with a healthy diet and regular exercise... even for people who don't lose weight.
Now, I don't generally cotton to the "golden mean" fallacy: the misguided notion that in any dispute between two opposing sides, the truth will probably fall in the middle. But in this case, I genuinely do think that both sides have some valuable ideas... and that both sides are missing some seriously important truths.
I completely agree that the fat-positive movement does often trivialize the very serious, extensively documented, no-joke health risks of being fat. I think they focus on their political ideology about bodies and feminism, at the expense of the actual scientific facts on the ground. I think they're often guilty of wishful thinking: of acting as if the mere act of saying "Fat is as healthy as not-fat" over and over again will somehow make it true, regardless of the medical evidence. And I think they dismiss the fact that, while it's fairly easy to be a healthy, active fat person in your youth, it gets increasingly harder as you get older.
I also think that when the fat-positive movement keeps repeating the "Dieting doesn't work" mantra, they support this view by stubbornly focusing on the stupidest, most extreme diets out there. It's certainly fair to point out that a lot of popular diets are essentially semi- starvation, guaranteed to make you crazy and miserable and ultimately guaranteed to fail. But it's also fair to point out that not all weight-loss programs are that dumb. (Of course, this is also true for fat-negative skeptics, who focus on the stupidest, most extreme forms of fat-positivism while largely ignoring the more moderate, pro- exercise- and- eating- right, "be as healthy as you can at the weight that you are" folks...)
And when the fat-positive movement insists that weight loss doesn't work, they're ignoring the fact that we now know a whole lot more about weight loss than we used to. Good, careful studies have been done, looking not at the details of specific weight loss plans, but instead at the 10% of people who do lose weight and keep it off, and what they have in common. And apparently, it doesn't matter so much what kind of diet or exercise plan they're on: low-carb, high-protein, low-fat, high-vodka, whatever. What matters is that they're counting calories, keeping food journals, weighing themselves regularly, getting lots of exercise, losing the weight slowly (no more than two pounds a week on average)... and seeing all these things as a permanent lifestyle change instead of a one-time thing.
(Of course, that does beg the question: Why are some people able to sustain behavior changes like these, and others aren't? Diets generally don't work partly because many diets are stupid and unsustainable... but it's also partly because people don't stick with weight loss plans even when they are reasonable. But why is that? There's a whole science about behavior change and why it's so hard... and we need to not frame it as a moral judgement about weak character. It's common across humanity. As a society, it's been like pulling teeth to get people to quit smoking and wear seatbelts. If we're serious about addressing the American obesity epidemic, we need to be looking at major social and political change about how we deliver food and design our cities... not just haranguing people about how fat they are.)
The fat positive movement also often claims that being fat is purely genetic, not behavioral... a claim that ultimately isn't supportable. Yes, there's clearly a genetic component: in a perfect world where everyone ate a perfect diet and got loads of exercise, people would still come in different sizes, and one of those sizes would be fat. Besides, it's not so easy to draw a bright line between "genetic" and "behavioral." Appetite triggers, for instance, may be genetic, some people may be born being more easily triggered by external food cues than others... but the triggers shape our behavior, and we can make choices to deflect those triggers, or alter them, or avoid them. But if it were true that fatness is purely genetic, then why are Americans -- and non-Americans who eat an American diet -- so much fatter than the rest of the world? And why are Americans so much fatter now than we were 50 years ago, or even 20? If size were purely genetic and eating and exercise behavior had nothing to do with it, none of that would be true. Evolution doesn't work that fast.
So yes, I think the fat-positive movement has been missing the boat. A lot of boats.
But I think the hard-line fat-negative skeptics are overlooking some important truths as well.
I think they often overlook the degree to which American obesity is not a personal problem, but a political one. I think they often overlook the ways that American obesity is created and exacerbated by deeply-laid social and economic structures: city planning based around cars instead of walking or biking; an economy in which people are overworked at sedentary jobs and don't have time for exercise; the phenomenon of food deserts (large urban areas with no access to healthy, unprocessed food); the multitudinous evils of the American food industry, with its emphasis on shelf life over nutrition and profit over absolutely everything. I think they overlook the ways in which weight loss is a privilege, far easier for people in progressive cities with ready access to healthy food... and for financially comfortable people who can afford trainers and gym memberships. (Both categories that I freely acknowledge I belong to.)
I definitely think the fat-negative skeptics can be dismissive of just how difficult and complicated this issue is, and how loaded it is -- emotionally, psychologically, indeed politically. Especially for women. (The practical mechanics of how I'm losing weight are insanely simple: counting calories, keeping a food journal, regular exercise, patience. The emotional and psychological and political mechanics are a minefield. Did I mention the endless processing, the obsessive planning, the hysterical crying fits in grocery store parking lots?) I think the skeptics often ignore our culture's obsession with an unattainable ideal of physical perfection -- especially for women -- and the effect this has on people who are never, ever going to even come close to that ideal, no matter how healthy they become. And I think the skeptics can be oblivious to the effect their words have on people: how, for a fat person, especially for a fat person who's tried more than once to lose weight, hearing something like, "Weight loss is simple, it just takes will power, just eat less and exercise more" basically translates as, "And if you don't, it's your fault, you're weak and lazy and you deserve to get sick and die."
I also think that fat-negative skeptics tend to overlook -- or are maybe just ignorant of -- the venomous contempt and hostile bigotry that gets aimed at fat people in our culture on a regular basis. I'm not just talking about third-graders who get teased at school, or the scores of personal ads seeking partners who are "fit and trim" (or, more bluntly, "No fatties"). I'm not even just talking about endless, degrading fat jokes in the media... and the way said jokes are a normal, unquestioned part of the media landscape. I'm talking about things like actual, well- documented job discrimination, and medical discrimination in areas that have nothing to do with weight. We need some sort of pride, some sort of positivity, just to keep from collapsing into depression and self-loathing.
And for all their passion about being reality- based and sciencey, the fat-negatives have a serious blind spot when it comes to one very important, extensively- documented fact about weight loss:
It rarely works.
Consistently, across the board, about 90% of people who try to lose weight either fail, or gain it back within a year. To my knowledge, every single method of weight loss that has ever been rigorously tested has a failure rate of roughly 90%. (Interesting tangent: If you join Weight Watchers, and you lose and re-gain the same 20 pounds three times? They don't count that as a failure. They count it as three separate successes.)
10% success. That's not a very good rate. And it's something that fat-negative advocates need to deal with. I mean, what the hell is the point of raising the Dire Warning Alert System and telling everybody, "Being fat is horrible for you, being fat will ruin your health, being fat can kill you" -- if, once you've successfully freaked everybody out, you don't have anything constructive to offer about what they can do about it?
Now, as Ingrid often points out: Quitting alcoholism or other drug addiction also has about a 90% failure rate, and you'd still advise addicts to kick if they can. The fact that weight loss is difficult and rare doesn't mean it's not worth trying. (And we are learning more about weight loss, and are beginning to get a good, science-based, reality- based picture about what works and what doesn't. Again: counting calories, keeping a food journal, regular exercise, regular weigh-ins, patience.)
But given that this 90% failure rate is true, and until it is no longer true, then at least some of the visions and goals of the fat-positive movement are still pertinent. The idea that it's useful to eat a healthy diet and get regular vigorous exercise -- even if you don't lose weight? As long as weight loss efforts fail about 90% of the time, that's a pretty damn important message to get across.
And here's a freakish irony: The ideas and ideals I learned from fat-positivism? They've been incomparably useful to me in my efforts to lose weight.
Here's what I mean. The degree to which I've had to alter my life in order to lose weight has been pretty dramatic. If I'd had to do it all at once, I probably wouldn't have done it at all.
But I already had a head start. I was already exercising regularly: not as much as I needed to for weight loss, but more than probably 90% of Americans, and enough to improve my mood and my energy, my sleeping and my libido, my joint problems and my mental health. And I was already eating a healthy diet: not low-cal enough for weight loss, but better than probably 90% of Americans, and mostly consisting of fruits, vegetables, whole grains, and lowfat proteins. So shifting gears from "generally healthy lifestyle" into "weight loss," while it was hard, was not nearly as hard as I'd thought it would be. I was already more than halfway there.
And a huge part of why I was more than halfway there was my fat-positivism, and the ideals I learned from that movement. I was flipping the bird at the corporate mainstream media industry that wanted me to look like Paris Hilton... but I was also flipping the bird at the corporate mainstream food industry that wanted me to eat a steady diet of Cheetos and Hot Pockets and Stuffed Crust Pizza. I was committed to being as healthy as I could be at the weight that I was... and that involved eating well and getting regular exercise. Goals that the fat-positive movement actively and passionately encourages. (The fat-positive activists I was reading, anyway.)
Plus, the fat-positive movement gave me the tools I've needed to frame my weight loss primarily as a health issue and not as a cosmetic issue: to pursue it, not to fit some mold of ideal womanhood, but for myself, for my health and the enjoyment of my life. If my efforts to eat better and get exercise had been entirely focused on the goal of looking better, I might well have given up long ago. After all, no matter what I do, I am never, ever going to look like Paris Hilton. Or even Heather Graham. I'm short, I have a square, stocky frame, and I'm 47. It's not gonna happen. But because of the fat- positive movement, I was already thinking of how I eat and exercise, not in terms of what society expected of me, but in terms of my own pleasure and health. So paradoxically, once my weight started being a serious impediment to my pleasure and health, it didn't take much to shift gears.
Yet at the same time, I'm ticked off at the fat-positive movement as well. I do think that I put this off for a lot longer than I should have, at least partly, because I drank the Kool-Aid. I bought the idea that I could be every bit as healthy at 200 pounds as I would be at 140. I pored over the handful of studies saying that weight loss was no big deal, and ignored the mountain of studies saying, "Is Too." I ignored the fact that my bad knee was getting worse, until it got almost too bad to do anything about it.
And the skeptical movement has also given me tools that I need to do this. Being part of the skeptical movement inspires me on a daily basis to face reality, no matter how difficult or emotionally loaded it might be. It inspires me to base my decisions, not on wishful thinking, but on the best hard evidence currently available. It's gotten me thinking more clearly about the evolutionary aspects of food and appetite and weight loss... and has thus given me some seriously useful practical strategies to bypass the triggers that evolved on the African savannah 100,000 years ago.
So I'm not sure what to do here. I'm ticked off at both sides. I'm grateful to both sides. I see truth and value, and stubborn obliviousness, on both sides. In my personal life, I'm just going to keep doing what I'm doing: taking what I need from wherever I can get it, doing whatever works for me to be as healthy and sane as I can. But as a writer, and as a member of two conflicting social and political movements, I'm not sure how to handle this.
Fast Food wasteland photo by Apathetic duck.