Fat Talk Free Week!

This week is Fat Talk Free Week. This article in the Huffington Post really captures what the week is all about. Dr. Rosenberg describes "fat talk" as "comments like 'I feel so fat in these clothes,' or 'do I look fat?' It can also be saying to someone else, 'You look great, did you lose weight?' This implies that lost weight is the metric of looking good."

I know I used to make self-depreciating comments in high school and early in college - it's just such a part of our culture and I think in many circles it's an expected way for women to talk. Starting in college, I began to stop saying things like that, because I started to realize that making those comments isn't just dissing yourself - it sends a message to others as well. I can't count the number of times friends of mine (many of whom are much smaller than me) have commented negatively on some aspect of their body ("My arms are so gross," "I feel like a cow"), and I've thought - what does that say about my body and how it looks? Obviously, their intention is just to remark on their own body/express their opinions about themselves - not to insult anyone else, but I think people often forget that their negative comments send a message to others about what's acceptable and what's not acceptable in terms of body size.

Here are some articles I've read this week that you might find interesting:

Interview: James Hansen on the Tar Sands Pipeline protest, the Obama administration, and intergenerational justice - Jerry Cope, Huffington Post
I've become really interested in the Tar Sands pipeline - which, if you don't know about it, is basically a proposed project to have a large oil pipeline go through the United States to link crude oil from Canada to refineries in Illinois, Oklahoma and the Gulf Coast. Leading climate scientists like James Hansen (a UI grad and Iowa native who heads the NASA Goddard Institute) and environmentalists (such as Bill McKibben) have said this pipeline would be "game over" for the environment and have gotten arrested for protesting it. I really hope Obama rejects the proposal.


Pedestrians on streets designed for cars - Lisa Wade, Sociological Images
Features some great examples of problems in the built environment

Men with disabilities face increased risk of sexual violence - Whitney Blair Wyckoff, NPR

Can the 14th amendment defend itself? - Linda Kerber, CNN Opinion
I just saw Linda Kerber speak this morning at the law school and it was very interesting (my friend who attends law school told me about the lecture and invited me to come with her). Ms. Kerber talks a lot about the importance of historical context in understanding the constitution. The 14th amendment is not something I had thought a lot about, but I think her take on why it is important in terms of immigration is fascinating.

Film Underscores Koreans' Growing Anger Over Sex Crimes - Choe Sang-Hun, NYT
A recent South Korean film about the sexual assaults of a number of deaf students in a school and the lax punishments the perpetrators got has "tapped into the widespread anger of official reluctance to take sex crimes seriously, and over how justice is served." Nearly a 10th of the country's population has seen the film.

Iowa Cancer Summit

The Iowa Cancer Summit was Monday and yesterday, and fortunately I was able to go yesterday. The Summit is an annual statewide event that brings together over 100 people involved in cancer control practices. A major theme at this year's Summit was the unveiling of the newly revised Iowa Cancer Plan, which is available to download online here. The plan is meant to guide cancer control practices across the state for the next 6 years and is separated into four major sections: Prevention, Screening, Treatment, and Quality of Life.

The keynote speaker this year was Dr. Laura Seeff, the Comprehensive Cancer Control Branch Chief for the CDC. Her talk was great; one of the take home messages was about the importance of policy and systems-level change, and that we should be sure to include efforts to change those instead of focusing only (or even primarily) on individuals. She also talked about the importance of working together with other chronic disease control efforts and groups dedicated to improving health in other ways to make sure we aren't all duplicating efforts and not being as effective as we could otherwise be.

One of my favorite parts of the Summit, however, was the Cancer Survivors Panel breakout session. Three cancer survivors spoke on the panel about their experiences. The speakers were Gail Orcutt, a radon-induced lung cancer survivor who is a tireless radon advocate and simply a wonderful person; Greg Cantwell, a stage 4 brain cancer survivor; and Gabbi DeWitt, whose mom passed away from cancer this spring. (The ICC, like the National Coalition for Cancer Survivorship, defines cancer survivors as those who have been diagnosed with cancer, those who are affected by a loved one's cancer, and caregivers). One major theme of their stories was the importance of having care coordinated. As a cancer patient, you see many different specialists, and sometimes they do not communicate with each other, meaning that major problems/complications can be overlooked and it can be very confusing. I was especially thankful for Gabbi's insights into the benefits of hospice. I think many times the focus in cancer treatment is how survivors are going to win their battle with cancer, but sometimes that is not possible, and that can be very difficult for people to accept or even want to talk about. Gabbi, who works in hospice herself, said that her mom was able to be on hospice care for 11 weeks before she passed, and that those 11 weeks were wonderful and "like a breathe of fresh air." Her mom was able to stay at home and spend time with her friends and family. For more information about hospice, here's a fact sheet from the National Cancer Institute.

This was the second Cancer Summit I've been able to go to, and it's always great to see so many great people dedicated to fighting cancer.
 
Anyway, before I got, here are some articles I've read this past week that you might find interesting:

Study Cites Increase in Throat Cancers from HPV - Denise Grady, NYT
Further support for the importance of the HPV vaccine and for the importance of vaccinating boys.


Hormonal Contraceptives May Raise HIV Risk for Men and Women - Scott Hensley, NPR Health Blog


Top 5 Unnecessary Health-care Costs - Jonathan D. Rockoff, WSJ Health Blog
"Doctors’ prescribing a brand-name statin, without first  checking to see if a lower-priced generic drug would cut a patient’s cholesterol sufficiently, results in $5.8 billion in excess health-care spending, according to the research letter published Oct. 1."


Should a Candidate's Weight be Part of the Conversation? - Katherine Hobson, WSJ Health Blog
My opinion to this question is a definite no.

Weight and health

I’m very interested in the relationship between weight and health, although I hold some unconventional views. I think that weight alone should not be used as an indicator of health and that focusing on weight loss as a goal in health interventions can have some unintended negative outcomes.

First, I will preface this by saying that I am not denying that the US population, on average, eats worse and is less active than it was in previous generations, and that this has led to poorer health outcomes. As a person interested in public health, I think there should be efforts (on multiple levels, not just individual) to improve our nation’s health. I also realize that we have, on average, gained weight.

While I recognize this relationship between our increasingly unhealthy environments/lifestyles and our increasing size, I don’t think that it’s as clear-cut as many in our society make it out to be. I believe that someone can have a technically unhealthy BMI (over 25) but still be healthy while someone who has a normal BMI can be unhealthy. Now, clearly there are countless credible studies that have found that people with higher BMIs tend to be at risk for an assortment of health problems that are less common among people with lower BMIs, but there are also a number of studies that complicate this apparently obvious relationship (for example: here, here, and here). And while perhaps on average someone with a BMI of 30 is more likely to have certain health issues than someone with a BMI of 20, this does not mean that all people with a BMI of 30 are unhealthy and that all people with a BMI of 20 are healthy.

I believe that our focus on weight as the primary sign of health and our obsession with weight loss as the way to gain health has lead to some unintended negative consequences: 

1. There are many very unhealthy ways to lose weight. If weight loss is the focus instead of adopting healthy behaviors regardless of weight loss, people may try to lose weight at any cost, even if it means actually being less healthy. 

2. People who have a normal BMI may think they’re healthy even if they aren’t eating well or getting enough physical activity, while people with higher BMIs who adopt healthy behaviors may become discouraged and think they aren’t healthier if they don’t lose weight. 

3. By conflating weight with health, people who do not have a normal BMI are automatically judged as being unhealthy, even if they actually are healthy/do have a healthy diet and exercise regularly.

As a society, we are very focused on losing weight as the key to being healthy, but I think there may be a different way to approach it. What about being healthy simply for the sake of health, not weight loss? This is what I like about Health at Every Size (HAES). I find this approach to health very interesting and others have argued that we should have a paradigm shift away from focusing on weight loss to HAES. Here, here and here are some published articles on the benefits of HAES.

Of course, it should go without saying that even someone who does have a high BMI and actually is very unhealthy (for whatever reasons) should still be treated as a human being and not discriminated against. Here’s an example of weight discrimination: this study found that the higher your BMI, the less your doctor respects you.

It should also be noted that the degree of agency people have in controlling their weight (and health in general) is greatly debated. Our society tends to put the blame largely on individual-level factors (usually focused on behaviors, but sometimes genetics are mentioned too). Public health professionals and some other experts have done an excellent job of pointing out other factors, including environmental and social.

I am not the first person to say these things, and many other people have written much more eloquently than me on these issues. I know many people feel passionately about this topic and may disagree with me. I love to discuss this issue, so feel free to voice your opinion!