Wednesday, February 20, 2013

Fat is a social issue

There was an excellent article in The Guardian yesterday on obesity by Rae Earl.

» Obesity epidemic: as a lifelong comfort eater, I understand the emotional pull of food

Some of the comments on it were idiotic. People said things like losing weight is just a matter of willpower, and all you have to do is to eat less and exercise more. If that were the case, there wouldn't be an obesity epidemic.

My weight loss

At the beginning of 2009, I was 18 stone, and lost four stone on Slimming World, which focuses on eating healthy and filling food, and still losing weight. It worked well for me until I became a vegetarian. I then maintained more or less the same weight for two years, but wanted to lose more.

I have recently lost another four stone on Lighter Life, which is a very low calorie diet. This works by switching the body into ketosis, which means that after the first 3 days, you are just not hungry; and weight loss is rapid. The programme includes counselling and techniques to help overcome the issues which caused you to overeat. It also switches you to food packs, which provide the right nutrition and are different to normal food, and on the Total programme, you abstain from normal food altogether and just eat packs. I found this really helpful for breaking the cycle of food addiction.

I find it almost impossible to lose weight without being on some kind of programme where there is an expectation that you will turn up every week and have lost some weight. Paying for the group sessions is also a big motivator. Also, Lighter Life and Slimming World were developed by former fat people, who actually understand what it's like to be overweight or obese.

Many weight-loss programmes don't offer support or techniques for maintaining your weight when you have finished your diet; Lighter Life offers maintenance help, continued access to packs when you need them, and continued counselling sessions.

Food addiction

Fattening food is addictive, but unlike other addictive substances, you can't just stop eating. We need food to keep us alive - you don't need alcohol, drugs, or nicotine (though of course they can be really hard to give up, too).

Eating food with a high glycaemic index (which means that the calories in it are released rapidly and used rapidly) produces a spike in the level of blood sugar, followed by a trough. Most people respond to the drop in blood sugar by eating again, probably something else that is high-GI. This is addictive behaviour.



If you are going for a run, then a high-GI spike may be good to give you the energy to get going; but it is not good if you are sitting at your desk. The aim of someone with a sedentary lifestyle should be to keep their blood sugar levels within the dotted lines on the graph, so as not to experience a trough which leads to eating high-GI food.

If you are addicted to tobacco, alcohol, drugs, etc., it is easier to remove yourself from environments where those things are available; and they are not necessary to life, unlike eating. Yes, one can switch to healthier eating, but that will probably only allow you to maintain weight; it is hard to lose weight by healthy eating alone.

The Weight Loss Resources site has a list of low GI foods.

Emotional stress

Most overeating is in response to emotional stress. I made a chart of my weight gains and losses over the years, and all of my overeating and subsequent weight gains were due to some trauma in my life. It is only by dealing with the underlying issues that I think I may have cracked it this time. (Only time will tell - but I am determined not to get so overweight again.)

Also, it can be a vicious circle - high weight leads to low self-esteem, so people self-medicate by eating more to make themselves feel better. That is not logical, but human emotions rarely are. This comment by Rickylicious on the Guardian article describes the vicious cycle of overeating and low self-esteem really well. Here's an excerpt; please do read the whole comment:
I hate being fat. I can't stop eating. I can't pull myself up by my bootstraps. I keep trying. I'm sick of being told by everyone I meet that I need to diet or exercise more. That much is self evident. Even to a stupid, ignorant fatty like me. I just get through each day as it comes as best I can. Then at the end of it all I eat, and eat again. Then I feel disgusted with myself. Worthless.
The Lighter Life programme includes techniques from transactional analysis and cognitive behavioural therapy to help people to understand why they overeat, and develop other coping mechanisms for emotional trauma, feelings of emptiness, and unhappiness. Even so, I still struggle with the temptation to respond to any little feeling of stress with a binge. I am still learning to manage my new lower weight, as I have only recently finished Lighter Life.

Social pressure

Just about every social occasion involves some pressure to eat fattening foods, or drink highly calorific alcoholic drinks. "Oh go on, have another one, it can't hurt". We call these people "feeders". Often they are people who have never had an issue with weight themselves, and so just don't understand which foods are fattening and which are not. The pressure to eat fattening foods is immense, especially at weddings and family gatherings, Christmas, work outings, coffee with colleagues, and so on. And it's hard to go to the pub and have soda water, especially if there are people who insist on offering you alcohol and think you are some kind of Puritan if you decline (fortunately my friends don't do this).

Car culture

I now live in Oxford, one of the most cycling-friendly cities in the UK (and even then it's sometimes scary) which also has excellent public transport, and is small enough to walk from one place to another. However, if you live in London, which is downright dangerous to cycle in, then that's just not going to be a good place to get exercise, or if you live somewhere hilly, it's difficult to cycle up those hills when you first start trying to get fit. The culture of driving everywhere (and constructing roads and other infrastructure so you have to drive to out-of-town shopping centres) is surely a major contributor to the rise in obesity.

Unhealthy food

Healthy food is harder to obtain, and more expensive. So many foods are packed full of processed starch, sugar, and fat; vegetables are more expensive. When I was doing the candida diet, which cuts out sugar and yeast completely, I had to visit three different supermarkets to get the products I needed. Most products are full of sugar. Loads of things are labelled "low-fat" but hardly any are sugar-free. Unhealthy food is widely available.  Restaurants have now started offering calorie-counted meals, which is helpful, but it is hard not to indulge in fattening things when everyone around you is doing so.

Other health issues

Many people are overweight or obese due to other conditions such as diabetes, thyroid conditions and so on. It is not well-understood how some people stay thin despite eating all sorts of fattening foods, whereas others only have to look at a biscuit to put on several pounds.

I am not diabetic or anything, but being obese caused me considerable joint pain, and my legs are still not straight as a result of this. Walking long distances is really painful when you are obese. Cycling and swimming are good because they do not put stress on the joints, but they are not available to everyone.

Exercise

Why are there more food shops than swimming pools? Why are gyms so expensive to join? Why do they play awful pounding music? What overweight or obese person would want to go to a gym full of skinny athletic people, when we are convinced they are looking down on us for being fat?

And the sheer awfulness of physical education in this country must be a major contributor to the lack of exercise of many overweight people. I hated PE at school - I have no hand-eye co-ordination so could not play ball games, I hated the picking of teams because I was always left till last (how humiliating), I was not very fit and already slightly podgy according to some (though I now know that I actually had a healthy BMI). I hated the competitive atmosphere, and the gendering of sport, and the way the bullies picked on me and my friends for being crap at sport, and were allowed to get away with it. Nowadays, I am told, there is the ritual humiliation of the bleep test, which is inflicted on pupils of PE, and sounds like a cruel and unusual punishment. I can honestly say that my experience of PE put me off all sport for decades. Nowadays I do yoga, cycling and swimming, but I do not see any of these as "sport". 

Unhelpful comments

The self-righteous, unsympathetic and generally unhelpful comments from others, such as "Should you be eating that?" or "Every time I see you, you are eating" (yes, because it's lunchtime!) or suggestions on how to lose weight, or comments that obese people die earlier and have heart conditions and diabetes and stressed joints, or that losing weight is just a matter of will-power, or eating less and exercising more, are really really unhelpful. 

Do the people making these comments not think that the obese person spends a considerable portion of their day mentally beating themselves up for being obese? They do not need you to add to the chorus of internal self-criticism. It just makes avoidance of the issue more likely, because the response of the obese person is to think, sod you, you don't know how it feels to be me, you don't understand nutrition or diet or metabolism, and so avoid the issue by creating a defense mechanism around the whole issue.

People don't feel they have the right to comment on other behaviour or appearance issues, so why do they think they have a right to comment on people's weight? You should never comment on someone's weight unless they themselves ask your opinion. If you have never been overweight, you can't understand the vicious cycles involved.

On the  other hand, when I was losing weight, it was nice to get positive feedback from people in the form of compliments on my new slim appearance. And many people approached it tactfully by saying, "You're looking well". As some people prefer not to get comments on their weight loss, this is probably a good idea if you don't know the person very well.

Personal choice

Nothing in this article is intended to be detrimental to people who are happy with their shape and size. If you are big and happy with it, good for you. It's completely rubbish that societal norms are geared towards being a stick-insect, and it's a fact that being underweight is more unhealthy than being obese.

I chose to lose weight because I found it physically painful carrying around the extra weight, and because I am genderqueer, I didn't like being curvy and buxom.

Thursday, February 14, 2013

An interesting conversation

I had an interesting conversation the other day. I got chatting to a woman in a shop, and the conversation ranged over a number of topics, until it settled on same-sex marriage.

So this woman had loads of gay friends (so she said), and she was OK with civil partnerships, and yet she was opposed to same-sex marriage. Her reason was "but it says in the Bible..."

So I said, "But what about David and Jonathan? The Bible says that David's love for Jonathan surpassed his love for women". Oh yes, said the woman.

Then I said, "And what about Ruth and Naomi? The vow that Ruth made to Naomi is used in wedding ceremonies." And I talked about how amazing Ruth's love for Naomi was, that she was prepared to go to another country and risk being sold into slavery because she loved her so much. (Thanks to Kittredge Cherry for wising me up to the story of Ruth and Naomi.)

And then I said, "God is Love, right? And LGBT people love each other, so that must be godly."

And it seemed that I had succeeded in changing her mind.

Now, if I had called her a "bigot" at the outset of the conversation, that would have been it - end of conversation. And I don't think she was a bigot; she wanted to understand, and she seemed genuinely pleased to be offered a different interpretation of the Bible.

So, be careful before you jump to calling someone a bigot before you have found out what their real views are, under a possibly very thin veneer of religious conformity.

Also, it helps if you know how to do liberal Biblical interpretation.