Monday, June 3, 2013

Big, Fat, Shameful Lies

Every now and then an article comes along, and it just blows your mind.  And not in the good, "I'm going to share this with EVERYBODY and harass them until they read it!!!" way, but in the, "Oh shit, is there any way I can get this pulled from the internets?" way.

Of course, that kind of knee-jerk reaction is patently unhelpful.  First of all, no, there is no way to pull anything from the internets ever, and more importantly, when free speech leads to bad speech, the cure is more speech, not less.  And thankfully, the internets always has plenty!  I can waste hours reading snarky responses to junk science, sexist propaganda, and other articles peddling untruths.  Such articles are so plentiful, and of such quality, in fact, that I very rarely ever write one of my own.  But every now and then the situation seems to call for one.  I wrote just such a response to an article advocating global veganism, and now I have to write one in response to an article advocating that fat people shut their cake holes and stop being disgusting gluttons.

Yes.  Seriously.  That's a summation of the article in question.  To be fair, it's couched in lots of gentle language and all but tearful apologies for being forced to speak such 'ugly truths'...but it's not couched in a whole lot of sound science.

That might come as a shock to you because in our country we're all pretty thoroughly indoctrinated to believe that calories translate precisely to fat, and that having a slender body type is a simple matter of hitting that 2,000 a day number every day.  If you're very confused as to what's wrong with that concept, well, there's a whole lot of research you can do, but I think this article from the blog, Shapely Prose is a pretty basic myth-busting place to start. Follow the links and learn, learn, learn! This is a particularly long, and particularly researched, blog post, because this is a really important issue, and I took the time to deconstruct the entire article by Dr. Hitchcock.  If it seems like too much for you to read, then just read the information at the link above, and share it with a friend.  You'll be doing so much good just by that alone.

Have you made it this far?  Sticking with me till the end?  Ready to tear a biased article to shreds??  Let's go!  As in my last article critique, I'll be going through this article paragraph by paragraph, citing each as it appears numerically from the top.  So point '3.' is written about the third paragraph from the top of the article, etc.

Here's the article in question: "Fat City: What Can Stop Obesity?" by Karen Hitchcock.   Read along, starting with the first paragraph from Dr. Hitchcock's article, then the critique of paragraph one below.

1. TL;DR: I once knew a really really fat American, and she wasn't a disgusting stinky slob! I won't even explicitly say that her husband was a lard ass.  I mean, obviously this fat woman couldn't be married to a non-fat man!

2. I kind of just want to keep going with the TL;DR format because it has such great humor potential: "I'm a huge asshole who judges other people for what they eat as if it's any of my damn business!"  But truthfully, I'd be taking the easy way out and skipping over a crucial point.  I really doubt Dr. Hitchcock measured those heavy, oily discs.  Half a meter is something like a foot and a half...I could easily eat a pizza a foot across as a meal. They also only did this once a month.  Healthy?  No.  Insane Aussie-mind-blowing gluttony??  No.  Don't even get me started on the 'huge', vomit-inducing bowl of guacomole. Guacomole with a spoon??  She could write a whole horror movie based on that image alone! What the hell does 'huge' mean?  Why do we care what Emily and her family ate?  Oh, right, because you're an asshole who judges people and makes vast assumptions based on one experience...

3. Dear Dr. Hitchcock, have you considered being evaluated for a possible eating disorder?  I'm not being glib; she's exhibiting what could be symptoms: Why are you so obsessed with what other people are eating?  And so afraid of fat?  You went to a beloved friend's house for dinner and...sat there with eyes as wide as saucers as her family ate like normal people?  And now you're a doctor and Australia is full of fat people!  You know, I suspect a good psychologist could get to the root of your fear of fat people.  Maybe it has to do with homesickness when you were studying abroad?  Did I mention your status as a doctor and the obesity rate in Australia has NOTHING TO DO WITH POOR GENEROUS, ENTHUSIASTIC EMILY AND HER FAMILY???

4. Oh look!  Another story about a fat person!  Louise likes to read literary novels and eat chocolate while sick!  And you can't bring yourself to talk to her about how her size may be affecting her condition ('as you press your stethoscope into her white flesh...' This is starting to sound like a fetish...and then you start talking about 'Puritan'! Honestly, it's too easy...).  It's pretty clear this paragraph is only in here to try to prove that Dr. Hitchcock is a sweet, caring compassionate woman who really doesn't want to hurt fat people, but they've given her no choice.  I'm going to interupt the snark for another actual point: you didn't cite your claim there that the most likely cause of life-threatening pneumonia was most likely her excess weight, but you're a doctor, and I'm busy, so I'll let it stand. The obesity didn't make her get pneumonia; it only made it more difficult for her body to cope with it.  Worth mentioning, sure, but it's hardly accurate to say that her fat has 'harmed her in ways she may not have realized.'

5. Oh thank God!  She admits it!!  "I no longer know what to do about the obese..."  I have a thought, Doctor.  LEAVE THEM THE FECK ALONE!  Yes, she's a doctor, but none of the conditions we commonly associate with obesity have actually been proven to be caused by obesity.  Not a damned one.  Treat the diseases being presented: diabetes, high blood pressure, heart failure, etc.  It's such a shame, though.  Instead of taking my advice she takes back the first intelligent thing she's said: "I have moments of clarity...(BASED ON WATCHING ONE OBESE PERSON EAT KIND OF A LOT OF PIZZA!)...and obesity seems simple: more in than out"  That's not science, Doctor.  You should know that.  The SCIENCE engulfs her in silly complicated things like genetics, and hormones.

6. We're finally getting to the heart of the matter.  Dr. Hitchcock loves reading articles like, "How I lost 25 Kilos".  Such articles are not found in scientific journals.  Perhaps we should try mailing her some of those with that headline taped over the studies showing how eating less only makes you lose weight if you restrict your calories extremely, and then increase your intake to a less severe caloric restriction FOR THE REST OF YOUR LIFE, such as those discussed in this article from the Times.    Her preoccupation with food, and her blind faith in the idea that ice cream or an extra slice of cheese will result in the vile punishment of extra cellulite, especially considering she's a DOCTOR, definitely suggests an unhealthy relationship with food and her body.

7. What is with this explicit description of Lena Dunham?  This feels the same to me as the description of 'pressing the stethoscope into soft, white flesh.' It continues to point to an obsession with other peoples' bodies.  Also, why is eating multiple cupcakes in a bathtub ok, but not eating a whole pizza once a month?  Oh!  I know, I know!!  It's because Lena Dunham isn't obese and Emily is!  Did I mention you're a fat-shaming asshole

8. I'm really confused by this paragraph.  I'm pretty sure it's just more of her digging for sympathy from her audience, but she's doing such a crappy job of it.  She'd be willing to hang out with smart, sassy, pissed-off girls, but she's pretty sure they'd look like her if they could.  Maybe Lena Dunham, too.  Why don't you call her and suggest she stop eating cupcakes in the bath since that's obviously all she'd have to do to look like a runway model?

9. First off, yes, that is an empirical question, and no, fat is not inherently ugly.  Have you ever studied history, Doctor?  Too busy reading women's magazines aimed at crushing your sense of self esteem (you need to stop; they seem to be working)?  Fat people are considered hot in cultures where fatness is rare.  What's considered sexy is often tied to societal signs of wealth: orthodontics, tropical vacations, and gym memberships (allegedly) contribute to a look our culture finds sexy.  Go back one-hundred years, and the teeth might still be ok, but the tan and lack of soft curves would be a total turn-off.  We may well see a triumph of will over gluttony (though that's not what's actually there) but to suggest that assholes like YOU pandering this myth that thin=healthy, like you're doing now, doesn't contribute to that equation, to suggest that the average person doesn't believe thin is healthy and fat is unhealthy is just reprehensible.  Why don't YOU take a little personal responsibility before you point fingers at your fat sisters?

10. The Framingham Heart Study, huh?  Well, a lot of people are questioning that study...but I won't even go there because I can't find a really reliable source for it, so we'll assume it's totally solid: if you read the findings on the study on Wikipedia, it turns out that back in the 1960's, a correlation was found between obesity and heart disease: obese people had a higher risk of heart disease.  Ever since, the vast majority of studies have shown no correlation.  The subject should be closed by now.  In fact, there's such a thing as an 'obesity paradox' where doctors like Dr. Hitchcock stand around and scratch their heads because OBESE PEOPLE COPE WITH HEART DISEASE BETTER THAN THIN ONES.  Check it out here: Science!  All those studies that show such dire consequences for weight gain?  There were funded by companies that sell weight loss products and methods. Yay Capitalism!  And guess what, Asshole.  You are earning zero bonus points from me for saying you 'wish it wasn't true' because YOU'RE IGNORING SCIENCE!  And the whole, 'I wish obese people could be considered beautiful' comment?  Someone should punch you.  Hard.  Obese people can be beautiful.  Obese people are beautiful.  Obese people are people just like you, you close-minded, self-centered douche bag. Do you honestly believe that no one finds cheek bones and long, slim thighs to be unattractive?  How did you make it through medical school?  Should I make some joke about Australian medical school now?

11. Just skip it. It's only another anecdotal story about how gross fat people are.  (Ew, sandbags??!!!??!?!)  I'm just wondering Doctor, if this person had a tumor obscuring his spine instead of fat tissue, would you be this disturbed?  Didn't think so.

12. Doesn't this sound barbaric?  Do we really hate fate people so much that we want them to go through with this?  Worse, do fat people really hate themselves so much as to voluntarily go through it?  If such extreme measures as these are the only way obese people can lose weight, doesn't that suggest that maybe they aren't supposed to lose weight?  That maybe that's just the way their bodies are?  I do so love her cavalier attitude about checking for underlying conditions that may be contributing to their struggle.  She checks for 'catastrophic hormone' disorders.  What about hypothyroidism?  What about depression?  What about genetic propensity?  Ah, but such things don't fit neatly into her dychotomy.  If you're obese, in her world, you must be a sloppy glutton (who eats huge, oily discs).  Your size can't be a coincidence, unrelated to your unhealthy eating habits and the diseases that have resulted from them.  Interestingly enough, the fact that people who go through these procedures often have their diabetes improve immensely and even resolve very quickly after the procedure, long before they've had time to lose any weight, only proves that excess fat was never the cause of the condition.

13. Wow, every time you eat you find yourself preoccupied with your esophagus squeezing down the food?  You weren't overweight at all but you lost over ten pounds?  I can't believe you are counseling other people about their relationship with food when it seems so apparent that you need such counseling yourself.  I shouldn't be surprised, though.  I had issues with fat people when I struggled with body acceptance issues, too.  It's why things like this piss me off so much, and why I'm such a huge proponent of fat acceptance.  We're teaching people to judge and hate other people based on how they look, and that's not making us love ourselves, no matter how thin we may be.

14. Look out!  It's another anecdote!  Strangely enough, she doesn't mention her brother being obese at all...could it be possible that he's NOT OBESE?  In spite of having high blood pressure??  I wonder what the 'ridiculous amount of food' is that he eats.  Does he get extra cheese on his cheeseburgers?  Does he eat pizza once a month?  I shudder just thinking about it.  Could it possibly be that if he quits smoking and drinking so much, his blood pressure would drop a good deal without his weight changing on iota?  Could it be possible that changing his diet won't change his weight one iota, either?  YES, DR. HITCHCOCK!  YES, IT CAN!

15. Just an aside: I can't believe she's still writing.  Apparently without a cocktail of drugs, fat people will die by thirty!  Where in the hell did all these fat people not taking fistfulls of pills come from, then??  You are not fitting Dr. Hitchcock's narrow worldview!  GO DIE, FATTY! Where are these cost percentages coming from?  Maybe she charges her fat patients more since she has to put up with how disgusted she is by them.  I can't deny that it's really hard to carry around a lot of extra weight.  You adjust, of course. One of the reasons fat people eat more food is because they have faster metabolisms.  Did I just blow your mind?  True facts!! It takes a lot more energy for a really heavy body to get around than a thin one, so the body burns a lot more calories.  And they still can't lose weight on a mildly restrictive diet!

16. What.  Do I even have to say anything?  I just...I don't even...gas guzzling cars??  Yes, Dr. Hitchcock, these are ugly sentences.  They also make ABSOLUTELY NO SENSE.  You are either a horrible person, or a horribly misled one.  Perhaps both.

17.So...did you help Nora get her diabetes under control by suggesting lifestyle changes and medications?  How about recomending she take cinnamon as a supplement, as it has been shown to help regulate blood sugar levels?  How about recommending Nora get a freaking pedicure for her unkempt feet?  How about that, Doctor?

18. Oh, I see. Instead of doing those things, you told her a major surgery that would make it impossible for her to consume food or interact in food/drink-centered social situations normally FOR THE REST OF HER LIFE  (If you'd like to learn about weight loss surgery...not the horror stories, mind you, but just the universally acknowledged results and side effects, and one person's not particularly unusual experience with weight-loss surgeries, check out this Web MD article, this Bloomberg Business Week article, and this blogpost on Shapely Prose. For even more balance, click on the link to the post about Heidi's choice to have weight loss surgery in the first paragraoh of the blog post I linked to, and the situation she was in that made it her only choice.) was better for her than...being fat.  I applaud you for at least talking about making healthy lifestyle choices.  I wag my finger at you for implying to her that she wouldn't eat cookies if she loved her daughter.  Way to feel remorse, Doctor, but it means nothing if it doesn't make you think critically about what you're telling innocent people who trust you to be a professional and know your shit.

19. So...the patient tells you they eat normally, even healthily, but you're assuming they're lying and actually eat two-dozen donuts in one sitting?  Ok, ok, they are here because they have serious diseases most often caused by an unhealthy diet, so some skepticism is warranted.  I believe, I hope at least, that these people aren't being referred to you for their weight alone, but for their somber diagnoses that are presumed to be related to their weight. Why in the world would you ask them what the largest meal they ever ate was?  Am I supposed to be impressed by that?  Eventually, you cajole them into admitting they eat 'mind-boggling' amounts of food.  So that would be something like...a couple of cokes in the afternoon?  A pizza once a month?  I'm not saying those are healthy eating habits, and if those choices are causing diabetes, or heart disease, then obviously they need to change, but those things will not make a naturally thin person obese.

20. So the specialist in the field is fat.  Thanks for letting us know.  I realize you believe that this has something to do with his credibility, and, you know, perhaps it does.  PERHAPS HE ACTUALLY HAS SOME GOD DAMN UNDERSTANDING OF HIS PATIENTS' SITUATION!  The poetic image of a sweating and red-faced fat doctor trying to explain real science which you cheerily ignore because it conflicts with what you learned about that person you met in the 80's is telling me a lot about your credibility, Doctor, not his.

21. Actually, Doctor, YOU CANNOT KNOW how another person experiences hunger.  You do not get to say if someone is genuinely hungry or not, unless that person is hooked up to scanners and measurers that can track in real time the state of this person's stomach, hormones, and brain chemicals.  I don't even know if that's possible, but I know you're not doing it. Also, Doctor, you haven't actually told us.  Do YOU describe to this miracle diet you seem to be advocating?  Do YOU go home and dump out all the cookies in your house?  Do YOU never eat popcorn or candy at the movies, or order an extra glass of wine because you're enjoying the conversation?  Why is it ok for you to eat these things, but not for someone who is fat?  Could it be...because you're a prejudiced asshole?

22. Well, insenstive recovering anorexic friend, if you look at the facts, only the most fat people, the most morbid of the morbidly obese, see increased rates of disease and death, whereas you don't have to be very underweight AT ALL before you're putting your health at risk.  Fish and chips may not be the healthiest food ever, but that infusion of fat and protein does do positive things for a body, whether that body's big or small.  And why is it that a week's worth of calories (actually if its a week's worth of calories for someone 200 pounds over weight, it's a couple more week's worth of calories for a small person) is ok for a thin person to eat, but not for a fat person?  If you can stay thin when you eat that stuff, does that make it magically good for you?  Only in Dr. Hitchcock's funny version of reality!

23. Yes, there's a lot of research being done on weight loss, and funny thing: in spite of all that research, we haven't figured out how to make it happen!!  Out of the millions of people in the U.S. who have tried to lose weight, only about 10,000 have managed to keep it off for at least two years.  Did you read that Times article I linked to earlier?  It explains the science behind that problem.  If you try to lose more than 10% of your mass, your body will fight you tooth and nail, and use every hormone and brain activity weapon in its arsenal to get that weight back onto you, for YEARS after you've lost the weight.  That's what the research tells us, Dr. Hitchcock.  Meanwhile, as you pointed out, billions of dollars are being spent tricking us into eating stuff that is not good for us.  Under these circumstances, it's unrealistic at best to suggest personal responsibility is sufficient to make an obese person thin, and it's a huge, unproven assumption to say it's necessary to make an obese person thin to make him or her healthy.

24. Oh, Dr. Hitchcock!  Could it be?  Could it be that you're getting it??  That an obese person and a thin person could, and likely do, have similar diets and similar caloric intakes, but one has a body chemistry that packs on fat, and one does not?? Spoiler alert: No.

25. Funny thing, Doctor, it DOES work that way!  When people are full, people stop eating! Some of those people get fat! Others do not!

26. So charming that you've listed 'fatness' as a consequence here.  What's wrong with 'fatness', doctor?  You've listed it separately from diseases and early death, which is the closest thing to the truth you've said so far: if you eat a crappy diet, you will not be healthy.  You may or may not also be fat.  I happen to think it DOES NOT MATTER IF YOU'RE FAT OR NOT! Apparently Dr. Hitchcock thinks it does. What a compassionate, loving individual!  She also thinks that the problem with fat people being depressed and getting married less often is with the fat people, and not with the JUDGMENTAL ASSHOLES LIKE HERSELF WHO WON'T MARRY THEM AND WHO JUDGE THEM AND MAKE THEM HATE THEMSELVES!

27. Yes, because shaming fat people is awesome.  You know, my husband last night tried to defend this article to me by pointing out that Dr. Hitchcock and I both feel that eating lots of unhealthy food makes you unhealthy, leads to disease, etc.  However, dear Dr. Hitchcock takes it as gospel truth that before you get ill, you will first get FAT, and getting FAT is pretty much the WORST THING EVER!!!  Whereas I believe the SCIENCE that says that we are all pretty much set in terms of how much fat our bodies like to carry, and regardless of how we eat (provided we don't go to extremes), we'll all be pretty much that size.  Basically this critique of this article is a blog post about fat acceptance: one lonely shouting voice trying to point out to you how the medical establishment shames and blames overweight people instead of helping them.  Show pictures of the liver overrun with fat, show pictures of limbs amputated due to diabetes. Don't show skin infections cause by folded over skin, because that has nothing to do with the health problems caused by the products in question for the vast majority of people.

28. We worry about them, but our solution is to put a physical impediment in place so if they continue the deeply entrenched eating habits they have now, they will risk catastrophic complications and possibly die.  Oh, alright then.

29. This poor guy.  He's been shamed into thinking that because of his size, he's not allowed to eat fried foods or cokes, and when he's tried to stop, he's been faced with a compulsion so strong, and frightening, that he's been unable to!  Surely the good doctor will respond with compassion and help in the form of counseling, etc.

30. Or, you know, more shame, and dismissal of his experience.  It's so sad to me that the patient thinks the weight is the problem, too.  If only he were educated to know better, to understand that using food for comfort is the problem he has, not being fat.  Maybe Dr. Hitchcock will set him straight and make that referral for counseling!

31. What a pleasant surprise!  She DOES make the referral!  Thank goodness, this one client has a shot at a real solution for his real problems, instead of the one Dr. Hitchcock thinks he has. And then she goes on to suggest that most psychologists suck at their jobs and don't help anybody...maybe she met a bad psychologist back in the 80's.

32. It makes sense to me that Dr. Hitchcock would think an obese person with a compulsive eating disorder would represent the norm.  After all, she believes that all people who are fat ate a bunch of crap to get that way, and she got so freaked out by watching a cartoon of the first stage of digestion that she started eating really slow and lost ten pounds when you weren't overweight to begin with.  However, she is wrong.  I'm sure the clinical definition of 'morbidly obese' is crap, because the BMI is crap (here's a cool flickr project where people post pictures of themselves, and their classification according to BMI.  Possible trigger alert for people struggling with a disordered eating mindset. Here's ten reasons why the BMI is crap), however, it may be true that there are certain extreme sizes that simply cannot be reached without the help of cheap, nutrient-free junk food.  Most of us eat that stuff.  Most of us aren't morbidly obese.  What does that tell you?  Oh, P.S., telling us to google something isn't a source.  That's actually called fat shaming.

33.Very true, there is a point, which varies considerably from person to person, when the body simply cannot support the excess weight it's being asked to support, and serious problems begin to occur.  If someone's size makes them incapable of walking, it's safe to say a state of health is being lost.

34. You don't actually know what it takes, if anything, to get that fat, Dr. Hitchcock.  You are ten pounds underweight, which actually is a BMI associated with serious health risks.  What do these facts about people who have lost large amounts of weight tell us?  By themselves, not much, but they do back up science that suggests dieting is much less healthy than being fat, and that fat is not an indicator, or a cause, of health problems. 

35. I have a bright idea, Dr. Hitchcock, which you may not have fully considered: if your tools as a doctor are not the appropriate ones to help a person who is indeed so fat that their health is being affected, why are you attempting to use them for this purpose?  Shouldn't you be referring the person to someone with the right tools for the job?  Shouldn't you be using the tools of a scientist: critical thinking, observation, testing, etc, to learn about the state of health of your patients and how they got that way?  I'm pretty sure there are lots of resources other than you, actually.  Where did you get that idea?

36. Now here's something I'm happy to quote Dr. Hitchcock on!  "Forget obesity as a disease; it's a ruse."  So so true!!  Obesity isn't a disease!  It's a state of optimum health for many many people!  Then she goes on to make all of these vast assumptions based on people who are made unhealthy by eating an unhealthy diet, and most probably coincidentally are also fat.  SHE is the one making obesity a disease.  Not the good doctor, trying to make people understand that fat people are fat people, not lazy gluttons in need of more self-control. 

37. You know, Dr. Hitchcock is totally right that too many of us are eating too much crap and not enough real food, and it's taking an expensive toll on our collective health.  But she completely discredits herself and throws all her efforts into the garbage by making this a conversation about fat, and how gross fat is.  That's fat-shaming.  It's not helpful.  It's not going to save anybody.  It's not going to change anything. 

38. TL;DR The Whole Article Along with the Last Paragraph: The choice was in your hands, Doctor, to open a real conversation about the issues of how "the free market" is being allowed to harm human beings by feeding us toxins and crap.  Instead, you contributed to the culture of fat shaming.  Go sit in the corner, Doctor, and think about what you've done.

Can you e-mail the good doctor and let her know all that is wrong with her article?  That would be amazing.

Live Omily,
~em

2 comments:

  1. If I may say, this may be your best post to date. Amen, sister. :) xo style, she wrote.

    ReplyDelete
  2. You may indeed, and thank you very much! :-D

    ~em

    ReplyDelete