Posts Tagged ‘Science of weight control’

Beginning to Weigh in on the Linda Bacon/Lucy Aphramor Paper

In Weight-Loss Maintenance on February 28, 2011 at 2:34 pm

The great thing about procrastination in blogville?  If you wait long enough other people do big chunks of your work for you.  I have, for some time now, wanted to post my impressions of the Linda Bacon/ Lucy Aphramor treatise, from January 24th of this year, Weight Science:  Evaluating the Evidence for a Paradigm Shift.  The shift they speak of, of course, is away from a weight-loss centered medical model to one of Health at Every Size, or HAES (trademark pending).  It is a densely referenced essay, with only eleven pages of narrative followed by 178 footnotes filling nine pages of their own.  Those footnotes deserve fair inspection and at least some random verification to make sure the authors are interpreting properly (a daunting task), and that has held me up some.  However, to critique such a treatise as this, it is only fair to start with a summary, and I thank others for coming through for me, brilliantly.

From the size acceptance community we have a lovely essay from Living 400lbs, and we have Big Fat Blog’s earlier quickie post on the topic. 

Since we can expect the size acceptance community to embrace a paper promoting HAES (which is rooted first in size acceptance), I found it more heartening to see that Canada’s preeminent obesity expert, Dr. Arya Sharma, not only posted a thoughtful summary of his own, but he ended by saying he is keeping an open mind on the topic.  This from a man whose bread and butter entails (where he deems appropriate and judicious) recommending bariatric surgery for his patients.  Unsurprisingly, he has a much rosier impression of the evidence-based benefits of bariatric surgery than Bacon and Aphramor or others from the size acceptance community who publish in journals.  (To my lay eyes, this debate is stuck in a state of limbo, these-scientists-say-X/but-these-others-say-Y.  And few scientists are creating studies that cover a significant time period, which should be required if they are to break the tie by the weight of their evidence, credentials or the consensus of their colleagues.)   Read the rest of this entry »


A “Meta” Post About This Blog

In Weight-Loss Maintenance on February 14, 2011 at 10:35 am

In addition to adapting the Rules of Engagement post for a “page,” and looking into how to get rid of the vulture advertisements as cheaply as possible, I have been making my way through the Linda Bacon/Lucy Aphramor paper supporting a Health at Every Size (HAES) approach to weight management.  I hope to post on it soon, but it’s turning out to be more challenging and time-consuming than I’d anticipated.  I am unable to breeze through it without checking at least some of the sources.  I mostly support its premise, and yet it makes me uncomfortable.  I think Barbara Berkeley touched on it in the comments at her own blog.  It reads as a manifesto, and that rubs me (and her) wrong.  It’s kinder and better sourced than Gary Taubes’s Why We Get Fat (also a manifesto), but the Bacon paper is a manifesto nonetheless.  And, as with Taubes’s book, I have no place in it, really, or at least my place is awkward.   Barbara’s ultimate response (in the comments) indicates she will return to her position of promoting weight loss, which is appropriate for her.  It’s her job, her life’s focus, and she does it with kindness and circumspection.  I will likely end up somewhere else, though I don’t know where that is yet.

The good news, the Bacon article isn’t messing with my weight, as Taubes’s book did.  As I read Why We Get Fat, I found myself falling into his regimen, compelled to decline counting calories, trusting my satiety to keep my weight in check (since I was increasing my fat intake).  My weight crept to the top of its range and hovered for days.  Then it went over my current range by a pound.  Ack.  And then another.  Ack.  Ack.  I’ve returned to my own tried-and-true regimen, and have some days seen a number in my range.   I think I’ll stick with what my body has prescribed for me.  Please accept that as my “final answer” and I will accept carb control or size acceptance as yours, and we’ll look at various topics with respect for our choices.  How wonderful that we ARE different, because we are much more likely to see something original between and amongst our experiences, rather than in a fray of dueling manifestos that blind us by calling up our own pig headedness. Read the rest of this entry »

Why We Are at War and What to do About It

In Weight-Loss Maintenance on January 26, 2011 at 11:14 am

I am still plodding through Taubes’s Why We Get Fat.  It’s slow going, because his language remains alienating.  He insults me with his word choice and tenor, and by asking me to throw out my narrow assumptions and replace them with his narrow assumptions.

First, his language.  He repeatedly refers to “the overweight and obese.”  Hasn’t he been in this field long enough to know how dehumanizing it is to define people this way:  to say you don’t have adiposity, you are your adiposity.  In this book, he’s writing for the lay audience, not the medical and scientific community whose brains are presumably immune to the influence of such short hand.  Because of this broad audience, it would simply be polite (I won’t marginalize it with the phrase “politically correct”) to talk about people, not conditions or characteristics who happen to walk, breathe, think, eat and poop.

His language is tinged with an anger that smacks of a martyr complex.  Apparently, his ideas are not venerated to his satisfaction, so, he believes, everyone who disagrees with him either lacks imagination, is ignorant and not very well read, is biased to believe that fat people are gluttonous and slothful (and he may have a point there, but not enough to justify his intense outrage), or is stuck in a post-World War II mentality that will not permit the equal consideration of ideas from scientists of German origin.  Huh?  Get real. Read the rest of this entry »

Unsolicited Review, Parts I and III

In Weight-Loss Maintenance on January 20, 2011 at 12:32 pm

My Mother advised me, when I was a child, that if I didn’t have anything nice to say, to say nothing at all.   But then she allowed that if I had constructive criticism to offer, I could do so if I began by saying something positive.  So, I will start by thanking Gary Taubes for the contributions he’s made to my life over the years. 

First I’d like to thank him for allaying my fears of dietary fat.  The world of women’s magazines had (in my yo-yo days) hijacked my brain and persuaded me to feed myself a completely unsatisfying diet.  I believe it was you, Mr. Taubes, who gave me back avocadoes and stir fry and salad dressing that has flavor.  You gave me permission to banish SnackwellsTM from my pantry forever.  How can I ever thank you enough?!       Read the rest of this entry »

Thoughts on Science, Optimism and Bias

In Weight-Loss Maintenance on January 7, 2011 at 12:46 pm

Happy New Year!  Hope you all had lovely holidays.  It’s good to be back at the blog, and back on the internet, for that matter.  (Long story involving words like #!%^&$!#!!, and a whole lotta bad Karma directed at AT&T.)

Between holiday adventures and internet mayhem, I managed to slip in a post about one of my weight maintenance peccadilloes – my ability to measure fluid in ounces using my gulp mechanism.  I must admit that when I get that personal, I do feel a bit self-conscious and self-indulgent, but I think it’s instructive – for me, mostly, but also for others who participate in the fray.  We broke into a lovely discussion about the admirable pursuit of goals, and when that pursuit crosses an invisible line and becomes something less noble.  I don’t think we reached any conclusions, but I came away recommitted to the idea that I should NEVER suggest, “if I can do this anyone can.”  Even if it’s true that anyone CAN do what I do, maybe not everyone should.  One person’s pursuit of a goal may be, in all likelihood, another person’s gateway to disorder.

Somehow, in the comments, RNegade was possessed to share a couple of science-related links.  (Whew!)  My favorite was this New Yorker article by Jonah Lehrer on the “Decline Effect” that happens to our sense of scientific certainty.   This “Decline Effect” is part of a larger problem with bias in science that misshapes our understanding of a variety of social and medical issues.  I put the phrase in quotes, because, as Lehrer notes, “This phenomenon doesn’t yet have an official name, but it’s occurring across a wide range of fields, from psychology to ecology. In the field of medicine, the phenomenon seems extremely widespread . . .”   

As I understand it, the “Decline Effect” happens when the scientific method, and all its noble precepts, leads a scientist (or team) to discover a statistically significant anomaly, Read the rest of this entry »

Not so Fast, FDA!

In Weight-Loss Maintenance on December 8, 2010 at 9:55 am

The buzz now, in size acceptance spheres and elsewhere, is the FDA’s presumed lowering of the BMI threshold for bariatric surgery involving laparoscopic bands. There is discussion among weight loss maintainers and maintainer aspirants at Lynn’s Weigh.   It’s interesting (but not surprising to readers here) that Lynn and many of her commenters are as uncomfortable with this presumed decision as the people discussing this issue at size acceptance sites, such as Fierce Freethinking Fatties and Big Fat Blog. I tried to enter the fray at BFB, and just made a mess on the comments page with my lengthy URLs, So I will give my thoughts (and links) here.

First, let’s clear something up.  It’s not a done deal.  The FDA rarely bucks a panel’s recommendation, but it can, and it hasn’t made a final decision yet.   It’s as though a motion has been made, and lacking discussion, it will pass in a few months’ time.  Maybe we need to enter the discussion.

In short, I think the FDA is being pushed too quickly, and with inadequate and premature evidence.  If it proceeds, then it does so on the recommendation of its Gastroenterology and Urology Devices Advisory Panel. While I’m sure these are fine people, it can be argued that the interests of bariatric surgery are well represented and consumer concerns may be, er, less so.

The panel of 14 includes general surgeons and other medical experts, as well it should, since it is charged with making recommendations on a variety of surgical devices for GI and urology procedures. But more specifically, at least five of the panelists are bariatric surgery True Believers:

  • Jon C. Gould, Chief of Minimally Invasive and Bariatric Surgery, University of Wisconsin
  • Thomas H. Inge, Director of Cincinatti’s Surgical Weight Loss Program for Teens since 2004 and has performed over 135 minimally invasive weight loss procedures for adolescents during that time  Read the rest of this entry »

This, That and T’other

In Weight-Loss Maintenance on December 4, 2010 at 6:52 am

Today I am short on time, but not on links, so I thought I might just throw them out and let you have at ‘em.

This article on not-so-healthy health bloggers appears to be Marie Claire’s mea culpa for the Maura Kelly fiasco that not only failed to ban fat people from Public Displays of Affection, but inspired several counter revolutionary (both live and virtual)  smooch-a-thons.  I had never visited the “healthy living” blog sites that Marie Claire informs me are known by fans as the “Big Six.”  (Hint:  If you ever go on the Who Wants to Be a Millionaire? game show, don’t make me your cultural literacy phone-a-friend.)  I have visited those sites now.  The food pictures qualify as pornographic, but the copy.  Whoa.  Is that what whippersnappers are reading these days?  Oh, boy.  Real Housewives of the Internet . . . on a diet.  ZZZZzzzzz. 

I prefer to read science and legit personal blogs, ones that lack the dazzling sheen of corporate sponsorship.  These “Big Six” all have the flavor of the self-appointed “in” crowd from high school all-growed-up.   I didn’t get deep enough into an article to get any diet advice, but if Marie Claire is correct about it, then it’s as wrong as the advice that I might have gotten in the locker room from one of the pretty girls at Rock Bridge High.

This second citation places a bet from some unlikely late comers to the Roulette Table .  They didn’t make it in time for our spin, but maybe they can win in the next round.  Our house pets and lab animals put a chip on black.  There may be other explanations than environmental chemicals for why these animals are getting fatter, but it certainly isn’t their decreased outdoor play, their love for video games, or their reliance on the Applebee’s Carside-to-Go window.  Maybe I need to rethink my seering hatred for Bovine Growth Hormone, however.  I doubt they are fed steak and milk products.  Ah, well, there are other perfectly good reasons to distrust Monsanto.  Round-up anyone?

Who Are We Here? Hint: “Squeak”

In Weight-Loss Maintenance on November 29, 2010 at 1:58 pm

When I started this blog I was hoping to find some like-minded and supportive individuals. Friends, if you will, who have also found themselves in an odd and skeptical place with regard to obesity and the research surrounding it, a place that doesn’t seem to exist if you accept only the gushy daily headlines about the latest weight-loss “discoveries.” I guess I wanted to find the other weight-loss killjoys at the water cooler, and while many reside at Big Fat Blog and other fatosphere locales, I always felt like an outsider. Talking about my weight-loss maintenance there would have been rude. But I wanted to talk about it. To share my mixed feelings, and find out whether there are others like me who are as confused by our cultural mythology as I am, and who may feel betrayed.

It’s not that I need more friends in my social circle. I have party friends, neighbor friends, tap-dance class friends, etc. I’m even on my church council of Deacons. However, in any certain geography, there aren’t a lot of people who are maintaining weight loss long term. There are even fewer people who are interested in the science of it to the degree I am. Moreover, there aren’t all that many people of any size who hate the weight-loss madness on reality TV and in the daily news the way I do. There are virtually no people where I live who are both weight-loss maintainers and size acceptance proponents, or, even, who are in one of those two groups but talking to each other. I wanted that, but didn’t trust that it existed.

Wow. We do exist! And I am so happy. Some of you have come by way of Big Fat Blog and the size acceptance chat boards. You forgive me my weight-loss maintenance peccadillo and accept me in the size acceptance community, even though I’m engaged in this Read the rest of this entry »

The Roulette Wheel Stops

In Weight-Loss Maintenance on November 22, 2010 at 7:12 pm

Well, THANK YOU for playing my game. It’s time to name a winner. And I gotta say, it’s not easy. Special appreciation to Jocetta for providing thought-provoking links (which I may purloin and post upon). And to DeeLeigh, for keeping Jocetta on her toes. And back at Jocetta, again, for accepting DeeLeigh’s toe-correction with grace!

Thanks to RNegade and DeeLeigh for a heated yet interesting discussion on the strength of the link between obesity and Type II Diabetes. It got us a little off topic, but it’s clearly a great topic for another day. Many of the White Labcoats have pronounced causation when it’s still clearly ONLY association. Maybe we, the lab rats, can gently suggest they research the outside factor(s) that may initiate both.

Yes, the Roulette table was confusing and confounding.  Thank you to all 23 players, many with multiple entries.  Vegas would get rich off of you. 

Now, I wasn’t asking what makes us fat (though I got a lot of good answers). I was asking what has changed to make us fatter in the last four decades. And Friday, I pooh-poohed the idea that our formerly virtuous behavior has collectively eroded. Today, I award a tie and identical copies of the GRAND CYBER GLOAT to Mo, Jocetta and RNegade, the proponents of genetics and epigenetics, which I didn’t even put on the board to begin with. But, indeed, the scientists who are advancing the best thinking are starting from the point of view that who we are, down to our very code, not what we do (unless it’s affecting that code) is making us fatter. Who we are impels us to eat when we know we will store too much energy – for our personal comfort and for the social rewards of a culture that detests fat people. Who we are as organisms (engaged in complex chemical reactions) has, on average, gotten more adept at storing energy. Read the rest of this entry »

BRRRRRrrrpupupup puhp puhp. . . The Wheel is Spinning

In Weight-Loss Maintenance on November 16, 2010 at 12:16 pm

So many wonderful and daring gamblers, along with a few cowards.  Thank you all for playing my game!

As I analyze it, Red bets have trumped black ten-to-five, with three totally confused people and/or shameless fence-straddlers, or six if you count all of NewMe’s multiple (charming) personalities. 

Today I point out the lines that struck me as funniest (without revealing anything about the contest winner) and I hand out special kudos to those who came up with new boxes for our ever expanding Big Fat Roulette table.  Let’s start with those:

  • Demographics.  Mulberry points out that an aging population is an ever fatter population.  Good call.  Add it to the black side.
  • Proffered by DeeLeigh:  Dieting during pregnancy makes for fat offspring.  While this is an interesting addition to the board, right beside it we would need to place a box for excessive weight gain during pregnancy.  Both, apparently, can cause the offspring to be fat adults.  In other words, always blame mothers regardless of what they do, unless it’s absolutely perfectly in the middle.  Sigh.  Oh, heck, blame mothers anyway, even if they do nothing but get pregnant while fat.  That’s three additions to the black side.  While it is personal choice, it is Mom’s personal choice that makes an offspring fat.
  • Attack-Laurel pointed out that prescription drugs frequently have weight gain as a side effect.  And as we use more prescription drugs we risk more of that side effect. Put that on the Red side. Read the rest of this entry »