The Fat Positive Feminist Skeptical Diet, Phase 2, Part 2: How Do You Know When Enough Is Enough?

This is Part 2 of a two-part post. In yesterday's piece, I talked about the process of switching from weight loss to weight maintenance... including the strange attraction of the process of losing weight, and the challenges of letting go of that process and embracing lifelong weight management. Today, I talk about how you even decide what a healthy weight might be... and how loving and accepting your body is part of that decision.

So, like I said yesterday: I am officially done losing weight. I've reached my target weight. Or, to be more accurate: I have reached the bottom of my target weight range. Or, to be even more accurate than that: I have made a final decision as to what my target weight range should even be -- something I wasn't sure of at the beginning of this project -- and have reached the bottom of that range.

But how did I make that decision?

Deciding when to stop losing weight was an interestingly tricky question. Much trickier than I'd thought it would be. I knew I didn't want BMI (weight to height ratio) to be my only metric of healthy weight. I knew that BMI, while a fairly good measure of healthy or unhealthy weight in populations as a whole, isn't the best metric for individuals. It can give some good broad strokes -- I knew that at five foot three and 200 pounds I should definitely lose weight, and that at 160 pounds I should probably keep going for a bit -- but when it comes to the fine-tuning, it's really not the best gauge. There's too much variation in how people of different heights are built -- different frames, different muscle masses, etc.

So once I got closer to my "ideal" BMI, I had to decide when to stop.

And I had to decide how to decide.

Which metric of healthy weight should I use? Body fat percentage? Waist circumference? Waist to hip ratio? Should I use body mass index after all? Some combination of the above?

Yoni Freedhoff (of the Weighty Matters blog), an evidence-based doctor/ weight loss expert I've been following and whose work I greatly respect, advises his readers not to get too hung up on external metrics. Instead, he says, we should find a weight we're happy and healthy at, one with a calorie budget we can sustain and not be miserable with. And there's some real value in that. When I was hovering near my "ideal" BMI and trying to decide whether to stop or keep going, one of the factors I considered was whether I could be happy dialing down my calorie budget a little more to lose a few more pounds... or whether that would restrict my eating too much for me to be happy with.

But there are also real problems with this approach. The whole point of this weight control project is that my own instincts about what is and is not a healthy weight are pretty broken, and I can't trust myself to make that decision without some external metrics. After all, I deluded myself for years into thinking that I was happy and healthy at 200 pounds... and that eating any less than I was eating would make me miserable. And on the other side of those broken instincts lurk eating disorders. Like I wrote yesterday, the process of losing weight itself has a strange appeal, with its constant cycle of victorious accomplishments and new goals to reach for. I could see myself coming up with a rationalization for continuing the process, even if I had no earthly health-related reason to do so. And since even at a completely healthy weight, my body still isn't the exact perfect body I'd choose if I could, it'd be easy to delude myself into thinking that more weight loss would solve that imperfection. I could see myself deciding that I'd be happier with my body if I lost just a little more weight... and then lost a little more... and then just a little bit more after that...

So I knew this "decide for yourself what weight you want to be" method wouldn't work. I didn't just want to paint a target around myself and call myself "done." I knew that my powers of rationalization would make that a dangerous path. It'd be way too easy, if my weight slid up again (or slid too far down), for me to just keep re-painting that target at every new place that I landed. I needed some other way of deciding.

But what else? BMI isn't great, for the reasons I detailed above. Waist-hip ratio isn't bad, it's pretty strongly linked to health outcomes... but the problem is that you can't really do much about it. Spot reducing (i.e., losing weight in one particular part of your body) doesn't work -- so if you want to improve your waist-hip ratio, all you can do is lose weight, and hope you lose more of it in your waist than your hips. Waist circumference? Seems a bit weird for that number to be the same for everyone, regardless of height or frame. But sure, I'd gotten that below the danger point. Was that enough?

I decided to go with a combo of BMI, waist circumference, and body fat percentage. I figured if all three were in a healthy range, I was probably fine. So when the first two were where I wanted them to be, I signed up with a hydrostatic body fat testing company -- you know, one of those places that measures your body fat percentage by dunking you in a tub of water -- and got that number.

And here's where it got interesting.

According to the Tub of Water Dunking Company (no, not their real name), my body fat percentage is 23%. And according to the company's calculations and categories, this puts me squarely in the "healthy" range. In fact, it puts me close to the bottom of that range.

I had my answer. I was done.

In theory, anyway.

But according to the Tub of Water Dunking Company and their calculations and categories, my 23% body fat percentage put me very close to the "athletic" range. And the moment they told me that, I found the idea almost irresistibly appealing.

I have never, in my entire life, considered myself "athletic." I've always been nerdy, indoorsy, a bookworm. Growing up, I was always a fat, gawky, "last picked in gym class" kid. Even when I lost weight in my teens, even in high school and college when I was taking tons of dancing classes and getting an A in fencing -- hell, even when I was dancing at the Lusty Lady peep show fifteen hours a week and making a living being professionally beautiful and sexy -- I never once thought of myself as "athletic." And now, finally, according to the Tub of Water Dunking Company, if I lost just a few more pounds of body fat, I'd officially be in that category.

And I thought: Maybe I'm not done after all. Maybe I should lose a few more pounds, and get my body fat percentage into that "athletic" range. Maybe it would be worth it to keep going, just a little bit longer.

It took some time, and some thinking, and a bit of Googling, to realize that something was very wrong here.

The Tub of Water Dunking Company had ranges for body fat percentages that they considered too high -- but they didn't have any that they considered too low. Their categories were Obese, Overfat, Healthy, Athletic, and Excellent. They had no category for You Don't Have Enough Body Fat. They had no category for You Are Dangerously Thin And Need To Start Gaining Weight Now.

And that was very disturbing.

So I did some Googling. Mostly to get a reality check on my "Yes, a 23% body fat percentage is totally healthy, you can stop losing weight now" answer... but also to get a reality check on my disturbance. And I got both. Yes, the body fat percentage range that the Tub of Water Dunking Company called "healthy" is also called "healthy" by the somewhat more reliable World Health Organization and National Institutes of Health. I really and truly didn't have to lose any more weight. Yay!

But here's where it gets really interesting. The body fat percentage range that the Tub of Water Dunking Company called "athletic," the WHO and NIH call "underfat." Yes, many athletes have a body fat percentage in this range... but athletes often have serious health problems, and sacrifice their long- term health to reach short-term goals. Serious athletic training is about achieving extraordinary feats of performance -- not about good health.

And I started thinking:

Why was I so eager to be in that "athletic" range?

Why was I so eager to keep losing weight?

A lot of it, I think, has to do with what I talked about in yesterday's post. There is a powerful appeal in the process of losing weight, and in the sense of accomplishment and approaching a concrete goal that it gave me. That's been surprisingly hard to let go of. I also knew how much harder weight maintenance is than weight loss, and I think I was nervous about embarking on this new leg of this project that everyone says is so much more difficult. So as relieved as I was at the thought that I was done, a part of me was disappointed, even somewhat scared... and eager to jump at an excuse to keep going. And again, even at my "ideal" weight, my body still wasn't the perfect body I would choose if I could ...and since weight loss had gotten me so much closer to where I wanted my body to be, it was seductive to think that a little more weight loss would get me a little closer to that ideal.

But some of the appeal, I'm embarrassed to admit, has to do with that word "athletic" -- and the feeling of validation and approval I could feel in having someone else, someone with some sort of objective eye, apply it to me.

Even if it was just the guy at the Tub of Water Dunking Company.

There's a Simpsons episode that perfectly illustrates what I'm talking about here. (Because there's a Simpsons episode to illustrate everything important about life.) It's the one where Homer and Marge go on the couple's counseling retreat, and Homer sneaks off to go fishing for the legendary giant catfish the locals are obsessed with, and thus be respected and admired. When Marge asks him, "By whom?", he answers, "Those weirdos down at the worm store!"

Why on earth did I care about those weirdos down at the worm store?

Why on earth did I care whether the guy at the Tub of Water Dunking Company thought I was an athlete?

And this is where I come back around to Yoni Freedhoff, and his "whatever weight you're happy with and can sustain without being miserable" metric.

The truth is that we don't really know what a healthy weight is. A lot of research is being done in this area, but right now, we just don't know. There are lots of different metrics, and not much agreement about which one is best, or where on each metric it's best to be. The answer is almost certainly a range, not a single fixed number. The range is almost certainly different for different people. And we don't really know exactly what that range is, or how wide it might be. We have some clear ideas of what a definitely unhealthy weight is... but we don't have a clear idea of what a healthy weight is. We have some very broad outlines... but for any given person, the question, "What should I weigh?" does not have an obvious answer.

So ultimately, I do need to take responsibility for this decision myself.

Yes, I need my decision to be evidence-based, informed by the best available research I can find. Yes, I need to avoid denialism about the serious health problems connected with overweight and obesity. (And, for that matter, denialism about the serious health problems connected with underweight and disordered eating.) Yes, I need to be aware of my human ability to rationalize and justify decisions that I find comforting and convenient. And so yes, I need to find reliable outside sources that will give me a good reality check.

But I don't need the guy at the Tub of Water Dunking Company to tell me I'm athletic. I know I'm athletic. I pump iron three days a week, most weeks. I'm doing bicep curls with 25-pound dumbbells. I can run up a flight of stairs without getting winded or breaking a sweat. I can dance for hours, and be disappointed and ready for more when the night is over. I can bench press half my weight. (Not that I would, usually: my trainer says bench pressing is a waste of time.) And when I flex my biceps, I look like a freaking Amazon goddess. I don't need to get my body fat percentage below some essentially arbitrary line, above which I'm just an ordinary schlub, and below which I am somehow magically transformed into Martina Navratilova.

I know I'm athletic. And more importantly: I'm healthy. My body does most of what I want it to do, most of the time. In fact, lately it's been doing things I never in my wildest dreams would have thought to ask of it. It's not perfect, and it never, ever will be. But it's strong, and it's sexy, and it's awake and alive and happy, and it connects me intimately with this universe I love so much.

And I'm learning to be okay with that.

Also in this series:
The Fat-Positive Diet, 7/28/09
The Fat-Positive Skeptic (Part 2 of 2), 7/29/09
An Open Letter to the Fat-Positive Movement, 11/11/09
The Fat-Positive Feminist Skeptical Diet: An Update, 3/8/10
Weight Loss and Strange Emotional Stuff: The Fat-Positive Feminist Skeptical Diet, Part 2, 3/9/10
The Fat-Positive Feminist Skeptical Diet, Part 3: The Actual Diet, 3/10/10
Some Evolving Thoughts About Weight and Sex, 3/17/10 (reposted here 6/28/10)

Comments

[DA]

Greta, congrats on getting what you wanted. That's awesome. The evidence based approach and cost benefit analysis are the best way I've seen to examine this. I have to be honest, I think of most of the "fat positive" movement much the same way I think of religious fundies or climate-change denialists; people who have a central dogma and are not going to be budged, no matter the facts. Kate Harding and her buddies, besides being thoroughly nasty people, go to some pretty extreme ends to manipulate data. I've been obese, morbidly so, during my adult life; now I'm athletic and strong, because I wanted to be, and made it happen. My mother (who was not in very good shape when I was a small child) did the same, and at 51 she's more fit than most 21 year olds I know.

I have to be honest, I don't worry THAT MUCH about adults eating too little or being underweight in America, for the same reason I don't spend a lot of time worrying about things like "reverse racism" or "arrogant atheists"; it's just such a numerically and socially insignificant flipside to the bigger problem that bringing it up at all seems like a diversionary technique most of the time.

[Dana]

This is a wonderful post. I have my own weight loss battle, including deciding what's right for me now as what was right when I had the luxury of exercising for two-three hours a day (dancing/theatrical combat/walking) every day. Don't have that kind of time now and my body has never quite recovered from the cessation of all that activity. I'm looking forward to reading the rest of your posts on this topic 'cause this one really improved my outlook and attitude on the topic.

[rose]

Quick question about that company: am I to understand that they say body fat percentage than "athletic" is considered "excellent"?

[closetpuritan]

My comment got eaten, I guess, so I'll try this again:

DA, I don't think the number of overweight people has anything to do with how seriously we take underweight problems at all. There's no reason to judge the seriousness of the problem by considering the number of BMI-underweight people as a ratio to the number of BMI-overweight/obese people. Increasing the number of overweight people without changing the number of underweight people doesn't help the underweight people; the average of an overweight person's weight and an underweight person's weight might be a BMI-normal weight, but that doesn't mean that you've just created two normal-weight people or that overweight people somehow "cancel out" underweight people.

And while there are fewer underweight than overweight people in most of the Western world, to the extent that being underweight is caused by health problems, physical or mental (e.g. anorexia), underweight people will die much younger than overweight people.

[DA]

closetpuritan

I find it very relevant, especially given how many FA types constantly use anorexia as a boogieman to shut up dissent, even bizarrely charecterizing opponents as "pro-ana" (I have never, ever met anyone who fi this description). In America, rampant obesity is a much, much more prevalent health risk than being severely underweight. If there were no social context for the two conditions, I'd agree with you. But how prevalent a problem is shold have a great deal to do with how seriously we take it, in the abstract.

[Kaleena]

Yup. I'm worried for the day when I no longer receive compliments for my body size when it's not new or exciting anymore. Good luck making the transition from loss to maintenance!

[closetpuritan]

But how prevalent a problem is shold have a great deal to do with how seriously we take it, in the abstract.

It's reasonable to say that we should talk more about problems based partly on how prevalent they are, but I don't think that means that we shouldn't bring up less-prevalent problems at all or that it means that they're unimportant. Anorexia is less common than obesity, but it's not THAT rare. (And I think the seriousness of the disease should be a factor as well, not just the prevalence--anorexia is less common but typically kills at younger ages than obesity, and both are more deadly and less common than athlete's foot.)

I also think it's not really fair to suggest that because other people have used underweight/anorexia to "to shut up dissent", we shouldn't talk about it in a more serious way. Surely you don't think that Greta Christina is using underweight "to shut up dissent" here?

[Angelika]

thank you ! both your posts have been the best I have read on the www and as your personal analysis. wow.
(also a positive feminist & atheist, non-american)

[Linda Koss]

Good luck to you. I'm maintaining a large weight loss for 3 1/2 years. The "compliment season" will wear off, and will be replaced by people who are *horrified* that you will continue your food restrictions to keep the weight off. There are just some people who want life to be a fairy tale. But that's o.k.

I think the most seductive part of being in the weight loss mode is that there is always some future where you can be better--firmer fleshed, prettier, etc.--whereas maintenance is what it is, for real. But if you enjoy the normal, instead of the drama of wondering if your clothes fit every time you try them on, or the happy drama of being the "weight loss queen" for the umpteenth time, you will find staying the same a lot of fun.

[MonaVie]

Normally, I'd tell you to use BMI because it is the widely used metric for losing weight. However, since you mentioned the a person's frame could differ, I wouldn't be surprised if losing weight for a big boned person becomes harder compared to others.

[17daydietrecipes]

If you think that diet food or other low fat foods can be consumed in large quantities then you may be totally wrong. Get motivated and start working for your dream look from today. With the constant onslaught of internet advertising yet more bogus claims are made all the time. Everywhere we see and hear different commercials for extreme weight loss prescriptions, diets, and methods. Are those ways safe? For many people, there is an automatic assumption that just because something is natural that it is safe. First and foremost the most important factor would be safety; losing weight must be done in a healthy manner to ensure success.

[MS]

I started getting concerned remarks about how I shouldn't get *too* thin. I still get those last anytime I happen to mention I'm on a diet.

[Natural Diet Pills]

It can give some good broad strokes -- I knew that at five foot three and 200 pounds I should definitely lose weight, and that at 160 pounds I should probably keep going for a bit -- but when it comes to the fine-tuning, it's really not the best gauge.