This is the Weight and Healthcare newsletter! If you like what you are reading, please consider subscribing and/or sharing! A reader sent me the marketing email for a heart health seminar that perfectly demonstrates many of the issues that we see with weight science, weight stigma, healthcare, and pharmaceutical industry money. I want to acknowledge that the people who put this together may have been well-intentioned, but that doesn’t erase the harm.
The "link" between being fat and diabetes has to GO. They've known for 50+ years that unwanted weight gain is a symptom of diabetes, not a cause, but that doesn't sell medications and quack notions, so it's now a very solid factoid believed by too many. Data over the past 20+ years has shown that issues linked to poverty - including 'forever chemicals,' general pollution, higher crime rates, bad and dangerous housing, and more, plus the stress from poverty itself (money struggles, having to work multiple jobs, juggling work & children without regular childcare, etc.) and racism are a very big contributor to bad health, including diabetes. Add to that the 5-year study published in April that says that the rate of diabetes in fat people is stable, but the rate in "lean" people, especially those of color, is climbing. It all says that body weight is not the smoking gun they desperately want it to be. (Trends in the Prevalence of Lean Diabetes Among U.S. Adults, 2015-2020 DOI: 10.2337/dc22-1847 )
On top of that, we have to remember the Look AHEAD study, which was going to prove that weight loss saved the lives of people with Type 2 diabetes, by reducing heart disease and CVD events. It was going to be a 20 year study but was stopped after 10 years, because people in both the "weight loss" and control groups were dying from CVD at the same rate. Weight loss did NOTHING to prevent diabetic-linked heart disease, so why should it do anything for non-diabetics?
I've seen that "50% of overweight/obese don't know it" before. I think Eric Oliver's "Fat Politics" might go into it? I know at least one of the early 00s books has citations on it.
The gist, as I recall off-hand: most "overweight" people and most "class I obese" people (which is the overwhelming majority) simply aren't fat. They will deny that either label should apply to them, and most doctors ignore the "have a fat talk" pop-up if the patient doesn't look like a fat person (eg, I would expect that "apple"-shaped women with large stomachs and thin legs get lectured at lower BMIs than "pear"-shaped women with large breasts, large thighs, and flat stomachs).
Agreed. I think the tell-tale phrase in the brochure (can I call it a propaganda sheet?) is "medical definition" Plenty of people meet the medical definition who don't look like the stereotype pictured on the front of the pamphlet. They can probably still buy clothes in regular stores and aren't otherwise subject to the fat stigma heaped on larger bodies. Of course they don't think they're fat. (but let's make sure to tell them)
I think this is one of those statements (I won't elevate it to statistic) that gets a pass from editors because people don't need citations for "things everyone knows are true."
Thanks for this explanation, it does elucidate a lot for me. My reaction to the "fat people don't know they're fat and must be told!" Has always been to wonder if the person doing the hand-wringing has ever actually talked to a fat person. We aren't "fat rock-shelteted Martians" as Kate Manne put it recently. The person saying this is probably the fifth person telling us this week.
I love how they always say what percentage of people with health issue X are fat but never do the reverse, percentage of fat people that have said health issue.
I love it when you pull the mask off these money-grubbers.❤️
I have previously griped about my experience with the Kaiser Permanente weight-phobic system and worried about my October diabetes check and how I would stand up for myself. It was yesterday. Lo and behold, the medical assistant, when I asked her, said that weight and height are optional measurements!!!! But I had to ask her; it wasn't voluntary. So that was 4 stars out of 5. During the physician portion, I asked her if she was familiar the DES effect on sons and daughters; she stopped cold, mumbled something and went into my history and saw that notation, then mumbled again "let me look at something" and clicked a few more times. NOT A WORD FROM HER about my weight or the losing thereof. Of course, I haven't read the patient take-home notes nor the physician notes yet (not filed yet). For a few moments there in the exam room, I felt like I was advocating for myself. Felt strong and capable. Thanks, Ragen - it's from reading your posts and the comments from all your wonderful readers.
Thank you so much Peggy! I'm glad and grateful for the advocacy work that you are doing (and I'm happy to have had a bit of a role in supporting you in that, though I wish all of it wasn't necessary!)
Setting aside all of the other nonsense involved in this - why would I, as a fat patient, voluntarily spend more time being condescended to and lectured at for being fat? I can't tell if this is some sort of box checking on the part of the health system or the product of a conference room divorced from reality.
Thank you for your breakdowns. The perpetual commitment to anti-fatness is so frustrating and ridiculous. That very first part of the ad is especially condescending.
This is utterly infuriating! But I take a modicum of comfort in the fact that the advertisers of this harassment program feel they need to call this a “heart health workshop” to attract an audience. (It’s clearly no such thing — it focuses entirely on weight, and has no advice for the 26% of people who aren’t O-word, but also have hearts). I also find it interesting tnat they feel they need to explicitly point out that the percentage of O-word people is “shocking.” To me this all suggests that “OMGbesity” by itself is not the draw it once was.
Why do they keep wanting fatness to be the blame for everything?!? Ughhhh (rhetorical question, really). I also wanted to send this "research" I stumbled upon on my Google news feed... Wondered what you thought about it. An argument for more dieting? No thank you. https://onlinelibrary.wiley.com/doi/epdf/10.1002/oby.23920
The "link" between being fat and diabetes has to GO. They've known for 50+ years that unwanted weight gain is a symptom of diabetes, not a cause, but that doesn't sell medications and quack notions, so it's now a very solid factoid believed by too many. Data over the past 20+ years has shown that issues linked to poverty - including 'forever chemicals,' general pollution, higher crime rates, bad and dangerous housing, and more, plus the stress from poverty itself (money struggles, having to work multiple jobs, juggling work & children without regular childcare, etc.) and racism are a very big contributor to bad health, including diabetes. Add to that the 5-year study published in April that says that the rate of diabetes in fat people is stable, but the rate in "lean" people, especially those of color, is climbing. It all says that body weight is not the smoking gun they desperately want it to be. (Trends in the Prevalence of Lean Diabetes Among U.S. Adults, 2015-2020 DOI: 10.2337/dc22-1847 )
On top of that, we have to remember the Look AHEAD study, which was going to prove that weight loss saved the lives of people with Type 2 diabetes, by reducing heart disease and CVD events. It was going to be a 20 year study but was stopped after 10 years, because people in both the "weight loss" and control groups were dying from CVD at the same rate. Weight loss did NOTHING to prevent diabetic-linked heart disease, so why should it do anything for non-diabetics?
Well stated! So tired of this crap. Wait, maybe it’s witchcraft that causes diabetes, since more women are susceptible…yeah, that must be it!
Space aliens. When in doubt, blame space aliens.
Brutal brutal brutal. I think the conflict financial interest irritated me the most. “Helping” professionals. Yeah right.
I've seen that "50% of overweight/obese don't know it" before. I think Eric Oliver's "Fat Politics" might go into it? I know at least one of the early 00s books has citations on it.
The gist, as I recall off-hand: most "overweight" people and most "class I obese" people (which is the overwhelming majority) simply aren't fat. They will deny that either label should apply to them, and most doctors ignore the "have a fat talk" pop-up if the patient doesn't look like a fat person (eg, I would expect that "apple"-shaped women with large stomachs and thin legs get lectured at lower BMIs than "pear"-shaped women with large breasts, large thighs, and flat stomachs).
Agreed. I think the tell-tale phrase in the brochure (can I call it a propaganda sheet?) is "medical definition" Plenty of people meet the medical definition who don't look like the stereotype pictured on the front of the pamphlet. They can probably still buy clothes in regular stores and aren't otherwise subject to the fat stigma heaped on larger bodies. Of course they don't think they're fat. (but let's make sure to tell them)
I think this is one of those statements (I won't elevate it to statistic) that gets a pass from editors because people don't need citations for "things everyone knows are true."
Thanks for this explanation, it does elucidate a lot for me. My reaction to the "fat people don't know they're fat and must be told!" Has always been to wonder if the person doing the hand-wringing has ever actually talked to a fat person. We aren't "fat rock-shelteted Martians" as Kate Manne put it recently. The person saying this is probably the fifth person telling us this week.
I love how they always say what percentage of people with health issue X are fat but never do the reverse, percentage of fat people that have said health issue.
I love it when you pull the mask off these money-grubbers.❤️
I have previously griped about my experience with the Kaiser Permanente weight-phobic system and worried about my October diabetes check and how I would stand up for myself. It was yesterday. Lo and behold, the medical assistant, when I asked her, said that weight and height are optional measurements!!!! But I had to ask her; it wasn't voluntary. So that was 4 stars out of 5. During the physician portion, I asked her if she was familiar the DES effect on sons and daughters; she stopped cold, mumbled something and went into my history and saw that notation, then mumbled again "let me look at something" and clicked a few more times. NOT A WORD FROM HER about my weight or the losing thereof. Of course, I haven't read the patient take-home notes nor the physician notes yet (not filed yet). For a few moments there in the exam room, I felt like I was advocating for myself. Felt strong and capable. Thanks, Ragen - it's from reading your posts and the comments from all your wonderful readers.
Thank you so much Peggy! I'm glad and grateful for the advocacy work that you are doing (and I'm happy to have had a bit of a role in supporting you in that, though I wish all of it wasn't necessary!)
Good grief.
GOOD GRIEF.
Setting aside all of the other nonsense involved in this - why would I, as a fat patient, voluntarily spend more time being condescended to and lectured at for being fat? I can't tell if this is some sort of box checking on the part of the health system or the product of a conference room divorced from reality.
Thank you for your breakdowns. The perpetual commitment to anti-fatness is so frustrating and ridiculous. That very first part of the ad is especially condescending.
This is utterly infuriating! But I take a modicum of comfort in the fact that the advertisers of this harassment program feel they need to call this a “heart health workshop” to attract an audience. (It’s clearly no such thing — it focuses entirely on weight, and has no advice for the 26% of people who aren’t O-word, but also have hearts). I also find it interesting tnat they feel they need to explicitly point out that the percentage of O-word people is “shocking.” To me this all suggests that “OMGbesity” by itself is not the draw it once was.
Why do they keep wanting fatness to be the blame for everything?!? Ughhhh (rhetorical question, really). I also wanted to send this "research" I stumbled upon on my Google news feed... Wondered what you thought about it. An argument for more dieting? No thank you. https://onlinelibrary.wiley.com/doi/epdf/10.1002/oby.23920