Metabolism- Transcript

Why Dieting Fails — Metabolism & Set point theory

(Content warning screen)

This video contains mentions of diets and dieting and detailed discussions of weight loss and how it works on the body.

***

Monster — You keep saying that diets don’t work, but I’ve lost 5 pounds a bunch of times! I’m on a great lifestyle wellness cleanse diet fasting plan, and all I have to do is just stay on it forever! IT’S SIMPLE. STOP MAKING EXCUSES!

Ali — Ok, but the definition of a diet working is that it should keep working, right?

Monster — NO EXCUSES!

Ali — You know, fine. Come back to me in 3 years and let me know if that diet is still working for you then.

Monster — Just do it forever! Until you die! NOTHING IS MORE IMPORTANT THAT HAVING A BODY THAT CONFORMS TO ARBITRARY CULTURAL STANDARDS!

Ali — Cause it won’t be.

Monster — **SCREAMING** (The words “Time to freak out” appear)

(Ok2BeFat intro)

Ali (wearing a pink squid hat) — For the purposes of this video and all my videos and everything I ever say on this topic ever — calorie restriction is dieting.

You can call it a lifestyle change. You can call it cleanse. You can call it wellness. You can call it whatever you want. Calorie restriction and monitoring is dieting.

(Hold up a drawing of a duck that says ‘Quack bih’) Your lifestyle change that includes calorie restriction quacks like a diet.

IT’S A DIET. There’s duck feathers everywhere. We all know it. I know it and you know it too.

You may be asking yourself, why is she wearing a squid hat? And the answer is, because I felt like it.

***

Ali- We all know someone who eats a lot, doesn’t really exercise and yet remains thin. And we all know someone who stays fat no matter what they try. Sure, they may lose some weight but they always gain it back.

Why does this happen?

Set point theory tries to answer this question by proposing that each person has a level of body fat that is normal for that individual person. That level of body fat is their individual set point, and this level will be different for different people.

If less than 1 percent of diets result in permanent weight loss. (A screenshot of ‘Dieting is Failure video, with a silly slowed down voiceover — check out my video on the rates of diet failure, they’re very high!)

Then there has to be a different explanation for people being different sizes, other than just some people are just bad and wrong, and should be yelled at forever, every day of their lives.

***

Monster — Hey. Fat girl. Can I tell you a little secret?

Ali — Oh YES, kind stranger! Please bless me with your wisdom that I certainly didn’t ask for, and haven’t received already from a million other random strangers, in every conceivable situation, and which I certainly didn’t ask for.

Monster — You just gotta stop drinking soda. Yep! Me? I stopped drinking soda and I lost 7 entire pounds. That’s it, you just have to have the willpower to put that 2 liter bottle down…

Ali — I don’t even drink soda. I mean if you put enough bourbon in, it’s barely even a mixer. More like a little light flavoring at that point. (exaggerated drinking and Ahhh noises **it was really Gatorade, y’all**)

Monster — Yep, just stop drinking all the soda that I’m imagining that you drink, and you could lose 7 human pounds, just like I did. Finger guns, finger guns, finger guns, finger guns. Yes.

Ali — Ok, firstly, you’re still a drawing, and you don’t weight even half a pound, so I am a little skeptical of your research.

Besides, I don’t understand why this keeps coming up. Because I could lose 7 pounds and literally no one would notice, including me. So I’m not sure why weird, weird and very aggressive strangers keep bothering me about this. These are not the same thing.

(Zoom) It’s not the same thing!

(Different shot, close-up) It’s not the same thing!

White text on a pink screen that says “It’s not the same thing” with a zoom, alarm sirens.

(New Scene)

If we say that fat people can just make themselves thin by eating less, then it would make sense that thin people should be able to eat enough to make themselves fat, if they wanted to.

Does it work that way? Well… no. Not really. **laughing**

In the 1960s, Dr. Ethan Sims wondered if the metabolic differences between fat and thin people were caused by different amounts of body fat. Or! Or if it was the metabolic differences that caused the people to be different sizes in the first place.

Basically, up until then, no one had ever stopped to wonder which came first — the Fatness Chicken! (holding up a drawing of a fat chicken) Cluck! Look at this chunky clucker!

Or! The Metabolism Egg! (holding up a drawing of a fried egg surrounded by colorful abstract shapes)

Metabolism!

Josh — (off screen) Is that what metabolism looks like? Those shapes?

Ali — Yes it is! This is what a metabolism looks like. It’s these shapes.

Josh — (off screen) Even the little bar shaped one?

Ali — Mmm hmm! That one too!

Josh — (off screen) What’s the curly one?

Ali — It’s vaporwave! I made it! I made it vaporwave! By hand. I know we all love vaporwave.

Josh — (off screen) Does everyone’s metabolism look like that?

Ali — Yes. (pause) Science!

Josh — (laughs off screen)

**

So Sims decided. He would take a group of thin people, turn them into fat people, just for a little while, and then study them to see if their metabolism changed as a result of the weight gain.

But there was only one problem. None of these people could gain enough weight!

To start, Sims took 4 college students and asked them to gain 20 percent over their usual body weight by eating extra food. None of them could do it. Some of them couldn’t gain even 10 percent over their usual weight, which for a person who’s 120 pounds, that’s only 12 pounds. Well, it should be easy, right? Just eat a lot of cake! Wrong.

Sims tried again in 1964 with prisoner volunteers in the Vermont State Prison. He screened for subjects who had no family history of fatness or metabolic issues. The men did not find it easy to gain weight, even when doubling their usual intake of food and reducing their activity levels. One subject was able to gain 28 pounds, but only by eating 7 thousand calories a day. And when he went back to his original style of eating, he began to lose weight immediately. Another subject was able to gain 20 percent over his starting weight — which is thirty pounds in someone started out at 150 pounds — but only by eating 10 thousand calories! A day!

If what everyone weighs is solely determined by what we are and aren’t eating, then why were Dr. Sims’ subjects not able to gain weight, and gain it easily?

In a different study of identical twins, researchers fed the twins an additional 1 thousand calories a day over what they should need to maintain their weight. The twins couldn’t maintain a higher weight either. And what’s even more interesting, while the twins matched each other for amount of weight gained, the amount of weight gained by different sets of twins varied from 9 pounds to 29 pounds.

Why did some people gain 3 times more weight on the same amount of calories as others?

(close up) Because of metabolism (draggy sound effect on the word metabolism- Big text insert)

**

What is metabolism?

Metabolism is the chemical reactions inside our bodies that keep us alive.

We take in energy in the form of food, which our bodies break down to use as fuel.

A lot of people have been taught every individual person’s weight is determined based on a calorie balance model. You hear people refer to it all the time when they say “calories in, calories out.”

“I’m a very judgmental person.” (laughs)

But this model is basically wrong. Or at least over simplified to the point that it is not just useless — it’s become actively harmful.

Metabolism is anything but simple.

Our weight and our appetites are controlled by a bunch of different hormones. These hormones send signals to the brain, which then sends its own signals called neurotransmitters, back to the rest of the body.

Scientists are still discovering new hormones and neurotransmitters all the time. Every new discovery has the potential to change our understanding of how people’s bodies deal with our food.

For example-

(Scene reading the list and badly mispronouncing the complicated name, which quickly scroll by as text)

leptin, insulin, adiponectin, GLP-1, ghrelin, glucagon, GIP, incretins, PYY, oxyntomodulin, amylin, melanocyte stimulating hormone, adrenocorticotropic hormone, neuropeptide Y, agouti-related protein, propiomelanocortin, gamma-aminobutyric acid.

You’re welcome!

***

A lot of people have this idea that somehow they are fully in control of their own bodies, like a little person inside their own brain, directing it what to do.

But anyone who has ever had the stomach flu or food poisoning should know that there are times when our thinking brain is absolutely not in control of our bodies.

Your body does not know the difference between a diet and a famine. And when you diet, your body thinks you could be in danger of starving to death. And if there’s one thing your body will fight for, it’s to keep you alive.

When you drop below your set point, the body has a lot of tricks to basically force you to eat.

The attention and reward parts of your brain become way more active. An experiment with subjects who had restricted calorie intake showed that this kind of brain activity was way higher when the subjects were shown pictures of high calorie versus low calorie food.

When you’re dieting, your brain makes high calorie food look way better to you than it might otherwise. And the longer the calorie reduction, the more blood goes to your cerebellum. Increased blood flow in the cerebellum is linked to hunger and appetite.

**Picture of cerebellum w/ words and arrows — more blood flow here = hungry**

I also have to tell you, that in addition to showing hungry people pictures of cheeseburgers and cauliflower, this experiment also had a group of subjects that either got a milkshake. Or, for the control group, what they called a “a calorie-free tasteless solution” that was supposed to feel and taste like spit.

Like spit!

Is that a part of my argument? No, it is not. But since I have to know about the spit experiment, now you do too.

(The word Science! With a horn sound effect)

(Finger guns) Boom.

Another experiment showed that calorie reduction was related to reduced activity in the prefrontal cortex, the part of your brain that helps you make decisions and not immediately act on your impulses.

(A screenshot of Ali in the squid hat with the word “Impulses”)

So your brain keeps you fixated on high calorie foods, and then throws the brakes away. And it gets worse the longer you struggle to stay below your set point.

Also, did you know? Body fat is a part of your hormonal system? Body fat makes hormones that control sensations of hunger and feeling full. As you lose body fat, the hunger hormones go up and the feeling full hormones go down.

When you diet, your body also tries to conserve fuel by slowing everything down and using every calorie as efficiently as possible. This slows down your metabolism. And it makes it harder to maintain a weight loss even on the same amount of calories.

These changes in hormones and energy usage can last a long time. Studies have shown over a year after stopping the diet, and even when all weight lost has been regained — hormone and energy use still had not returned to their pre-dieting levels.

And now let’s turn to the mental health effects.

Now we’re back to talking about Dr. Ancel Keys, a frequent topic of Ok2BeFat videos

(An Ancel Keys/Mean Girls meme- why you are so obsessed with me?)

In the 1940s, Dr. Ancel Keys, conducted an experiment into the effects of famine that would come to be known as the Minnesota Starvation Experiment.

The men were allowed to eat 1600 calories a day and also greatly increased their exercise levels.

And yes, I know what you’re thinking. That that is way more calories than most people eat while on a diet.

(close up) But it’s also way less calories than you actually need.

The UN Convention Against Torture requires that prisoners be fed a minimum of between 2,210 and 3,345 calories a day to prevent torture by withholding food.

I also just wanted to remind everyone on the Left that the George W Bush administration used the existence of the diet industry in America as a reason why it was totally ok for them to torture prisoners in Guantanamo Bay with starvation.

(Picture of George W Bush with the words “Because Fuck That War Criminal”)

The Minnesota Starvation Experiment subjects became completely obsessed with food. They talked about food. They dreamed about food. They lost interest in anything else.

Sound familiar, anyone who’s ever been on a diet? Or been within 20 feet of someone else on a diet? Or any kind of calorie restriction?

(Text- Warning Self Injury Discussion)

Calorie restrictions affected the mental health of one man so badly that he chopped off three of his own fingers with an axe. To get out of the experiment.

(FACE reaction)

Dieting has also been proven — with Science! — to be inherently stressful, physically as well as mentally.

This study is pretty cool- the researchers took women who wanted to diet and split them into three groups.

One group restricted their food intake to 1,200 calories a day and kept detailed food diaries of everything they ate.

One group was given prepackaged food by the researchers. So while the subjects were restricting calories, they didn’t have to do any of the like, mental work of tracking the calories.

And there was a control group wasn’t asked to do either.

The women’s stress levels were measured by tracking how much of the stress hormone cortisol was in their saliva.

Which they did by having their subjects chew on a cotton pad until it was totally filled up with spit! And then they tested the spit pads!

It’s so cool!

(An inaccurate reenactment — marshmallows stand in for the spit pads. Ali is doing a comedy by putting a lot of marshmallows in her mouth)

Ali — **muffled noises**

Josh (off screen) — Are you feeling stressed now?

Josh (off screen) — Are you feeling stressed?

Ali — Mm hmm

Josh (off screen) — How stressed are you feeling?

Josh (off screen) — Is your stress level increasing?

Ali — **muffled noises, shaking head**

Ali — I don’t wanna do this anymore. Ughhhh, it was a mistake! I’m never going to be able to eat a marshmallow again.

***

It turned out that it didn’t matter if the subject was trying to track calories or not — restricting calories on its own caused stress.

The elevated cortisol levels caused by chronic stress are linked to heart disease, high blood pressure, diabetes, cancer, and reduced functioning of the immune system.

And also weight gain.

Dieting can cause the problems that are blamed on fatness.

Which brings me back to this guy (holds up the drawing of the troll monster)

Your set point is where your weight stays when you don’t think about it or do anything about it. Barring any health or medication issues that can cause weight gain or loss, most people’s weight will stabilize once they stop paying so much attention to it.

A stable weight that can go up or down about 15 to 20 pounds without activating the body’s defenses against starvation.

So when this guy (show drawing) loses 7 pounds around the same time he stopped drinking soda, he’s still within his set point. And that experience can’t be extrapolated out to mean that it would be easy for someone to lose half their body weight.

The ‘I stopped drinking soda’ argument is really weird and ridiculous (sighs) and oh my god, it’s so common. But no one should take that seriously. Thin people who say this ridiculous thing are like rich people from rich families who claim they made it all on their own.

And to the people who say — ok, if dieting doesn’t work, what am I supposed to do instead?

Well. I don’t really want to tell you what to do, and I really couldn’t even if I did want to. The kind of health commandments that really sell well on YouTube are not what I do. Because there’s no health recommendation that works for absolutely everyone.

Some people can’t eat many vegetables because they have intestinal issues that make digesting vegetables hard.

Some people have physical limitations that make exercising difficult or impossible.

It’s better to make health goals that work for you and not worry about what other people are doing.

And you’ll have better results if those goals don’t have to do with obsessing over your weight or with counting calories.

You can decide you want to lift heavier weights and work towards that.

And you can decide how many servings of fruits or vegetables you want to eat in a week and work towards that.

You can decide to meditate or do stretching exercises.

You can decide you need more sleep. And you probably do!

It’s really up to you.

Generally, choices that work for you will be the ones make your body feel good, and whatever works for one person may not work for another.

That’s really it.

It is! That’s it!

That’s all you have to do.

***

(The Monster dancing on Foxy & Hodge as visuals, with this as voiceover)

And that is metabolism!

As always, a huge thank you to all the fat activists — past, present and future. And to my patrons!

If you liked this video or found it helpful, you can also support me on Patreon, see the link in the notes below the video.

The notes also list all my sources and provide a link to a transcript.

Please like this video, tell me what you think in the comments, and share it with everyone you know. Make some new friends and show it to them too! And subscribe!

For my next video, I want to show y’all a bunch of the experiments I read about for this video that I think are super awesome, but didn’t really fit well into this one.

***

(Text, no sound- ‘The diet industry is a capitalist parasite that would not exist in a just world.”)

***

( Weird Riker face meme)

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Sources —

“The Dieter’s Dilemma” by William Bennett and Joel Gurin.

“Experimental obesity, dietary-induced thermogenesis, and their clinical implications” by Ethan A.H. Sims; Clinics in Endocrinology and Metabolism

Volume 5, Issue 2, July 1976, Pages 377–395

https://www.sciencedirect.com/science/article/pii/S0300595X76800278

“Secrets from the Eating Lab” by Traci Mann, PhD

“The Response to Long-Term Overfeeding in Identical Twins” by Claude Bouchard Ph.D., Angelo Tremblay, Ph.D., Jean-Pierre Després, Ph.D., André Nadeau, M.D., Paul J. Lupien, M.D., Ph.D., Germain Thériault, M.D., Jean Dussault, M.D., Sital Moorjani, Ph.D., Sylvie Pinault, M.D., and Guy Fournier, B.Sc.; New England Journal of Medicine, 1990; 322:1477–1482

https://www.nejm.org/doi/10.1056/NEJM199005243222101?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dwww.ncbi.nlm.nih.gov

“The Metabolic Storm” by Emily Cooper, MD

“Caloric deprivation increases responsivity of attention and reward brain regions to intake, anticipated intake, and images of palatable foods” by Eric Stice, Kyle Burger Sonja Yokum. NeuroImage, Volume 67; February 15, 2013; Pages 322–330

https://www.sciencedirect.com/science/article/pii/S1053811912011408?via%3Dihub

“Circulating glucose levels modulate neural control of desire for high-calorie foods in humans” by Kathleen A. Page, Dongju Seo, Renata Belfort-DeAguiar, Cheryl Lacadie, James Dzuira, Sarita Naik, Suma Amarnath, R. Todd Constable, Robert S. Sherwin, and Rajita Sinha; The Journal of Clinical Investigation; September 19, 2011

https://www.jci.org/articles/view/57873

“Dieting in the Torture Memos” by Tara Parker-Pope, New York Times AskWell Blog, APRIL 22, 2009

https://well.blogs.nytimes.com/2009/04/22/dieting-as-an-interrogation-technique/

“The Great Starvation Experiment” by Todd Tucker

“Long-Term Persistence of Hormonal Adaptations to Weight Loss” by Priya Sumithran, M.B., B.S., Luke A. Prendergast, Ph.D., Elizabeth Delbridge, Ph.D., Katrina Purcell, B.Sc., Arthur Shulkes, Sc.D., Adamandia Kriketos, Ph.D., and Joseph Proietto, M.B., B.S., Ph.D.; New England Journal of Medicine; October 27, 2011; 365:1597–1604

https://www.nejm.org/doi/full/10.1056/nejmoa1105816

“United Nations Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment: Consideration of reports submitted by States parties under article 19 of the Convention; Second periodic report of States parties due in 2007” 12 February 2009

https://www2.ohchr.org/english/bodies/cat/docs/AdvanceVersions/CAT-C-ALB2.pdf

“Low Calorie Dieting Increases Cortisol” by A. Janet Tomiyama, PhD; Traci Mann, PhD; Danielle Vinas, BA; Jeffrey M. Hunger, BA; Jill DeJager, MPH RD; and Shelley E. Taylor, PhD; Psychosomatic Medicine. 72(4):357–364, May 2010

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2895000/

Dieting is a failure- Transcript

Hi, everyone. It’s Ali from Ok2BeFat. And it’s time for another episode of the Fat Activism Basics.

In this video I will be discussing weight and weight loss. I will also be using the words “obesity” and “overweight” in the context of discussing and quoting scientific studies, even though these are not words I would normally use.

This is The Failure of Dieting

When fat activists point out that fat people are routinely discriminated against in our culture, the inevitable response is — well, if you don’t like being discriminated against, why don’t you just lose weight?

Now. Is it really ok to harm an entire group of people just because you don’t like what they look like? I would say extremely no. And not only no, but that it’s an wildly unethical position to take in the first place.

I object to the entire framing of the issue that fat people should somehow have to prove to the people who hate us that we don’t deserve to be hated. It’s not my job to prove to you that I’m a person.

To even agree to debate my humanity is to lose, because I would have to agree that fat haters have any right to pass judgment on me.

I absolutely reject that idea. I will never agree to a framing that positions me as less than human or as somehow having to prove my humanity to anyone.

So why do a video about diets in the first place?

Because a lot of fat people who are being subjected to fatphobia think that their mistreatment is their own fault. That if they could just do it right, just this once, everything will change.

People are wasting their time, effort, and money on a lie. A lie that harms them and steals from them, not just money but time.

The lie that with enough effort a fat person can be turned into a thin one. A lie that tells them their pain is their own fault.

That lie must be fought, pulled out at the root and exposed. Because no matter how the weight loss industry tries to dance around the fact — diets don’t work. No matter how hard you try to rebrand them as lifestyle changes — diets don’t work.

Every single fat activist can tell you — 95% of diets fail over time. And what we generally mean by that is that 95% of people who lose over 20 pounds will regain it within 5 years. Almost always, dieters will not only regain the weight they have lost, they’ll end up at a higher weight than before they even began.

So where does this 95% number come from? In her book “Losing It”, Laura Fraser points towards a study from 1959 by Dr. Albert Stunkard at the University of Pennsylvania medical school.

Dr. Stunkard undertook a review of the studies into weight loss available at that time, going back thirty years to 1938. He criticized the conclusions of almost all the available research. These studies had skewed their own results by excluding people who quit before the end of the research period or people who were otherwise considered non compliant.

Dr. Stunkard argued that if someone drops out of a weight loss program, that the program should be considered a failure for that person. Which seems pretty sensible. If you quit in the middle of a test, it generally counts as a failure everywhere that isn’t diet research.

There were already hundreds of studies on weight loss in 1958, but when Dr. Stunkard applied his more stringent standards to the available data, only 8 studies made the cut. Not 8 percent. 8 total.

Stunkard’s standards are —

Number 1 — Studies must be conducted in a clinical setting and not rely on self-reporting.

Number 2 — Everyone who starts a weight loss program should be counted as a participant when calculating final results.

People who drop out should count as having failed the program.

And Number 3 — Studies must conduct long term follow-up to see if people actually maintain any weight they lost.

We know that weight regain occurs over time, so a study that doesn’t follow its subjects for a clinically significant number of years is not giving an honest account of how attempts at weight loss act on the body.

Of the 8 studies left, Dr. Stunkard found that only 4% of what he called “grossly overweight” people lost as much as 40 pounds. And of the patients who had lost weight, after 2 years, only 2% of them had kept it off.

We haven’t seen any research since 1958 that contradicts these original findings. Most of the studies into weight loss still do not pass the original Stunkard test.

Does it make sense for doctors, scientists, and governments around the world to insist that people can lose weight permanently when the topic has barely even been properly studied?

Most scientific disciplines would require actual proof to make the kinds of sweeping statements we see people making about weight loss every single day.

In 2007, Traci Mann, a professor of psychology at UCLA, published a study called “Medicare’s Search for Effective Obesity Treatments: Diets Are Not the Answer”.

Mann reviewed the research on the effectiveness of calorie restricting diets. At that time, Medicare policy had just been revised to pay for “effective treatments” of obesity. This change was a major windfall for the weight loss industry, which could now count on a new and extremely lucrative income source, the United States government.

Mann’s 2007 review of the research into dieting shows that “one third to two thirds of dieters regain more weight than they lost on their diets”.

Mann also found that even these dismal numbers are most likely underestimating the potential weight regain of dieters over time, due to methodological problems that bias the studies towards a more successful view of weight loss maintenance than is actually warranted.

Mann suggests that if dieters were followed for longer than the longest studies, that weight regain might be even worse.

Mann’s discussion of the problems with the research in 2007 lines up pretty well with Stunkard’s conclusions in 1959.

-The lack of follow up over a significant enough period of time, when it is known that weight regain over time is THE critical issue when it comes to the effectiveness of any weight loss method.

-The lack of rigorous clinical trials with a real control group. Especially the problem of selectively including and excluding study participants with an eye towards influencing the outcome of the study overall.

Mann highlights a study from 1995 where the authors reported excluding two of the study participants from the final results because “inclusion of the two patients strongly skewed the results against weight loss maintenance”.

Participants are also regularly excluded from the final results of weight loss studies for either not losing enough weight during the initial study or for quitting completely or dropping out of the follow ups. Drop outs are regularly not counted at all, instead of counted against the effectiveness of the weight loss method, which they should be.

So if the generally accepted number of weight loss success stories is only 5% — even though if we are really basing the numbers on Dr. Stunkard’s 1959 research, it really should be 2% and not 5% — what happens when we talk about really really fat people?

Not just the 25 pounds every thin person is dieting for, but the people who would have to lose 100 or 200 pounds or more to meet their BMI chart requirements.

How successful is weight loss for those people — the ones everyone pretends to be so concerned about?

You would be hard pressed indeed to find a single fat person who doesn’t know all about dieting and who hasn’t tried it themselves. If it was truly so easy to make a fat person into a thin one, permanently — why do fat people continue to exist?

It’s not usually for the lack of trying to become thin — the world is made into such a painful place for fat people, there’s barely a one of us who hasn’t tried (and tried more than once) to escape into the promise of thinness.

At least one study has put the likelihood of very fat people achieving a BMI under 25 at a less than 1% probability. A BMI of 25 is where the overweight category currently begins.

The “Probability of an Obese Person Attaining Normal Body Weight: Cohort Study Using Electronic Health Records” study used medical data from the UK to follow 278,982 people from November 1, 2004 to October 31, 2014, and showed a likelihood of reaching and maintaining a BMI under 25 for the highest weight group at 1 in 608 probability for women, which is a 0.1644% likelihood of success. And for men it was 1 in 362, which is a 0.2476% likelihood of a successful diet.

It seems like to me that giving dieting even a 5% chance of working is giving it too much credit.

We are constantly subjected to all sorts of wild claims about how healthy it is for people to lose weight, when it hasn’t in any way been proven that it is even possible for people to lose and maintain weight loss.

So while we’re here… IS it healthy for people to lose weight?

Paul Campos lays out the problem with dieting as a health recommendation really clearly in The Obesity Myth.

“More Americans than ever are dieting: On any given day, approximately 70 million adults are dieting to lose weight, and another 45 million are dieting to maintain their current weight. These percentages have tripled over the course of the last generation. And the result? Americans weigh on average 15 pounds more than they did 20 years ago.”

Campos also notes that millions of Americans are consistently trying to lose about 25 pounds, often on the advice of their doctors. Even though the research on yo-yo dieting is clear that repeatedly losing and gaining weight shows an increase in mortality rates.

Glenn Gaesser discusses this research in Big Fat Lies, citing the “Exercise Intensity and Longevity in Men: The Harvard Alumni Health Study”. Men who had dieted showed nearly double rates of type 2 diabetes, high blood pressure and heart disease as their classmates who had never tried to lose weight.

Higher rates of heart disease have been found also in the Multiple Risk Factor Intervention Trial and the Framington Heart Study.

And okay, you may say — haven’t you picked apart the idea of mortality rates as overblown in a prior video? Are mortality rates important, or not?

And I would say… which mortality rates?

If argument is that the epidemiological comparisons that are used to show mortality rates are a valid and an important scientific measurement for individual people, then what about the same types of mortality rate studies that show that people who weigh more live longer?

What about the studies that show that repeatedly trying to lose weight, regaining it and trying to lose it again — that this never ending loop of dieting is linked to increased mortality and disease rates?

Somehow those studies and those mortality rates just disappear when the topic of fat people is brought up.

Either studies showing mortality rates are important and can be relied upon, and we should dig into them and see what they actually say. Or they aren’t reliable and we should treat them with skepticism in ALL cases, including in the ones that seem to condemn fat people.

So which is it?

I am personally inclined to distrust studies of mortality rates unless the discrepancies are very large and hard to attribute to anything else. In the case of fat people versus thin people, we are talking about really small differences. Please see the BMI part 3 video for a further discussion of how the statistics regarding these studies can be manipulated.

But if we are going to use mortality and disease rates as a way to determine what is considered risky behavior, as so many people want to do, then surely trying to lose weight must be a heavier risk than just being fat.

I have to say, I find it extremely callous and cruel the ways people use these studies against fat people. Shaming the subjects of a study for dying is extremely gross and it’s wrong.

Shoving links of these studies at fat activists and screaming that we’re going to die is pretty ugly behavior. Also… you’re going to die too. Just fyi.

But let’s say you don’t want to rely solely on epidemiology. I certainly don’t.

What other evidence do I have of the danger of weight cycling?

How about multiple animal studies?

In the 1950s and 1960s, researchers conducted a number of animal trials of what we now call yo-yo dieting or weight cycling and found damage to blood vessels and the heart. The animal evidence, replicated in different experiments and among different types of animals, repeatedly shows that a period of restricted food followed by a period of expanded calorie intake produces high blood pressure and blood vessel damage.

But what about case studies of humans, you may ask? Well, in 1944, our friend Dr. Ancel Keys conducted the research into famine known as the Minnesota Starvation Experiment. In this experiment, 32 men were put on a low calorie diet for 24 weeks. During the re-feeding stage, the scientists noticed that many of the men seemed to be in danger of congestive heart failure, with 1 man needing to be hospitalized for severe heart problems.

32 people not a big enough case study? I agree. Let’s take a look at the survivors of the Nazi siege of Leningrad in World War 2.

From September 1941 to January 1942, the Nazi forces cut off the food supply to the city, putting the entire population on a starvation diet. In 1943, Russian doctors examined 10 thousand people who had survived and found that the amount of high blood pressure in the population had increased by between 100 and 400 percent, depending on the age of the subject.

And by 1944, the rate of blood vessel damage seen in autopsies in a Leningrad hospital had gone from less than 6 percent to 55 percent.

Glenn Gaesser notes, “If just a single cycle of losing and gaining weight can strain the cardiovascular system and damage blood vessels, what happens when a onetime episode becomes a recurrent pattern? More damage.”

And now is the time where someone inevitably sends me that article from The New York Times from 1999. It’s called “95% Regain Lost Weight. Or Do They?”. Because when you google for something like “95% of diets fail debunk”, this article is the first thing that comes up, after a couple of results that reference it.

So let’s talk about the claims in this article. I encourage you to go read it yourself. There’s a link to the article in the source notes below.

And now when someone inevitably dumps a link to it in the comments, we’ll both know that they didn’t bother to watch through to the end of the video.

The New York Times article is an argument that the Stunkard standards are too strict. Except it doesn’t really even make that argument openly, as it relies on noting that Dr. Stunkard did clinical trials on only 100 people, but does nothing to mention his survey of the entire available body of research.

The researchers quoted in the article try to discredit the Stunkard study as not credible due to a small sample size, without mentioning that he had reviewed and rejected the majority of the available dieting research for being not scientifically rigorous.

I feel that this omission is deliberately misleading, as it boils down the Stunkard study to one clinical trial, rather than acknowledging the larger critique of the majority of research into dieting as incomplete and deceptive.

So if the Stunkard standards are too strict, what are these researchers proposing instead? The National Weight Control Registry, a collection of self-reported information about weight loss.

If you are willing to say that you have lost 30 pounds for the duration of a year, you too can be counted as a success story by the National Weight Control Registry, a project that the article notes is funded by “financing from drug companies and other sources”. What other sources? I don’t know. I sent an email to them to ask, but I haven’t heard back.

Now, it should go without saying that self reporting is not a better way to scientifically track weight loss over time than a clinical trial. It’s a worse way, we all know that, right? Because there’s no way to double check people’s self reported figures, when if you had them in a clinical environment, researchers would be taking their own measurements and not relying on self-reporting.

Additionally, a single year is not enough time to label a weight loss attempt as a success. If dieting works so well that fat people can be made thin for the entire rest of their lives, as people love to claim — then we should easily be able to see successful diets in their second and third decades. But we don’t see that.

We see outliers and we see people repeatedly losing and gaining weight, which has been proven by science to be more dangerous than just being fat.

In her article in the Journal of Nutrition Education and Behavior called “The National Weight Control Registry: A Critique”, Joanne Ikeda points all this out and more. She mentions an article by the Registry researchers in 2003 which shows that even among the so-called success stories represented by the 2,400 Registry participants included in one of their studies, that 72% had already regained weight from when they had first registered.

And 23% of the participants who were mailed a follow up survey did not return it. Those people should count against the figures as failing their weight loss maintenance, and yet the Registry researchers do not count them at all. Because the Registry is completely based on self-reporting, we can only track the weight regain of the people who are willing to admit it.

And then we have the totality of the numbers themselves.

To quote from the Ikeda article —

“…using conservative estimates of the prevalence of dieting for weight loss in the United States, it appears that 44% of women and 29% of men are dieting at any one point in time. The US census current population estimates for men and women over the age of 18 years are 100 million 994 thousand and 108 million 133 thousand, respectively. Using these figures, it appears that there are 76 million 800 thousand people dieting.

If 5% of them are successful at permanent weight loss, approximately 3 million 800 thousand people will be eligible for enrollment in the (registry). According to the (registry) Web site, there are currently 4 thousand people enrolled. So the researchers can demonstrate a “success rate” of 0.001%, which is not even close to the dismal 5% estimate cited in the scientific literature.”

The National Weight Control Registry is a joke. It proves nothing, except that when it comes to dieting, people are willing to engage in all manner of special pleading that diets do work and for everyone, when that’s not at all what the real science shows.

Not when it is subjected to rigorous scientific standards.

Dieting doesn’t work. That’s simply a fact.

**

And that’s the end of the Failure of Dieting.

Please see the notes for a list of the sources I consulted for this series.

All my love and thanks to all the fat activists around the world — past, present and future — who are doing such amazing and fantastic work.

And thank you to all my supporters on Patreon — you make it all possible, and I love you for that!!

You can support my work on Patreon at patreon.com slash Ok2BeFat or you can make a one time donation at ko-fi.com slash Bad Fatty Ali

See you again soon!

Sources —

Losing It by Laura Fraser

“The Results of Treatment for Obesity- A Review of the Literature and Report of a Series” by Albert Stunkard, M.D.; January 1959, The Journal of American Medical Association

https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/562795

“Medicare’s Search for Effective Obesity Treatments: Diets Are Not the Answer” by Traci Mann, A. Janet Tomiyama, Erika Westling, Ann-Marie Lew, Barbra Samuels, and Jason Chatman, University of California, Los Angeles

https://cloudfront.escholarship.org/dist/prd/content/qt2811g3r3/qt2811g3r3.pdf

The Obesity Myth by Paul Campos

Big Fat Lies by Glenn A. Gaesser, PhD

“Exercise Intensity and Longevity in Men: The Harvard Alumni Health Study” by I-Min Lee, MBBS, ScD; Chung-cheng Hsieh, ScD; Ralph S. Paffenbarger Jr, MD, DrPH; Journal of American Medical Association, April 19, 1995

https://www.ncbi.nlm.nih.gov/pubmed/7707624

“Diet-induced hypertension and cardiovascular lesions in mice.” By G. T. Smith-Vaniz, A. D. Ashburn, and W. L. Williams; Yale Journal of Biology & Medicine, October 1970

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2591559/pdf/yjbm00170-0005.pdf

“Probability of an Obese Person Attaining Normal Body Weight: Cohort Study Using Electronic Health Records.” By Alison Fildes, PhD, Judith Charlton, MSc, Caroline Rudisill, PhD, Peter Littlejohns, MD, A. Toby Prevost, PhD, and Martin C. Gulliford, FFPH, MA; American Journal of Public Health; September 2015

https://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.2015.302773

“95% Regain Lost Weight. Or Do They?” By Jane Fritsch, The New York Times, May 25, 1999

https://www.nytimes.com/1999/05/25/health/95-regain-lost-weight-or-do-they.html

The National Weight Control Registry- http://www.nwcr.ws/

“The National Weight Control Registry:A Critique” by JOANNE IKEDA, MA, ; NANCY K. AMY, PHD ; PAUL ERNSBERGER, PHD ; GLENN A. GAESSER, PHD ; FRANCIE M. BERG, MS ; CLAUDIA A. CLARK, PHD ; ELLEN S. PARHAM, PHD, RD, LD, LCPC ; PAULA PETERS, PHD; Journal of Nutrition Education and Behavior, July–August, 2005 Volume 37, Issue 4, Pages 203–205

https://www.jneb.org/article/S1499-4046(06)60247-9/pdf?code=jneb-site

https://en.wikipedia.org/wiki/Special_pleading

Transcript- Debunking the Fatness Death Stats

Debunking the Death Statistics

Hi, everyone. It’s Ali from Ok2BeFat. And it’s time for another episode of the Fat Activism Basics.

In this video I will be discussing weight and weight loss. I will also be using the words “obesity” and “overweight” in the context of discussing and quoting scientific studies, even though these are not words I would normally use.

This is the Debunking of the Death Statistics.

Since death statistics are commonly used as a tool to frighten fat people and to discriminate against them, it’s important to take a close look to make sure that this information was arrived at in a way that makes sense and scientifically rigorous.

Spoiler — These stats don’t meet those standards. At all.

The most commonly used number for the amount of deaths by fat is 300,000 people per year in the United States.

Where did this number come from?

When the pharmaceutical company Wyeth was in hearings with the FDA to get approval for their new diet drug in the 1990s, they used the 300,000 deaths per year figure 7 different times in those hearings.

Fen phen had deadly side effects, something the company already knew at the time but that they had hidden from the FDA. Instead they sold the FDA on a risk-benefit analysis that alleged that the benefits of even a tiny amount of weight loss were higher than the risks of a diet pill.

The benefit being saving those ubiquitous 300,000 people from fat death.

Where did Wyeth get this figure from? No one at the company seemed to know. We know quite a bit about the internal workings of Wyeth regarding the approval and sale of fen phen due to the enormous civil lawsuits brought by the people harmed by this diet drug and the families of those who died as a result of taking it.

The entire fiasco is covered by Alicia Mundy in her book Dispensing with the Truth.

An internal Wyeth company memo discovered during the civil trial referred to the 300,000 number as having “never been substantiated”.

The original source for the figure appears to be a study from 1993 by McGinnis and Foege who proposed a 300,000 death figure “due to poor diet and physical inactivity”, without ever once mentioning body size. This figure was immediately misused by the media and other research articles as 300,000 deaths by fatness, when the original study said nothing of the sort.

McGinnis and Foege tried repeatedly to correct the misuse of their study. In 1998, they published a letter stating that “the figures… applied broadly to the combined effects of various dietary factors and activity patterns…” They also tried to draw attention to the fact that they had explicitly noted in their study that it would be difficult to sort out the contribution of any single factor, such as body size.

The abstract to their study notes that the numbers cited in the study should be viewed as approximate. It also says that social and economic status and access to medical care are also important contributors to mortality, but that they were not able to quantify the impacts of those factors for this study.

In 1999, David Allison published a study defending the 300,000 number as THE number of annually dead fat people. You may remember him from my previous video, BMI part 3 — he’s the guy who told Scientific American that his dire warnings about fatness were just “back of the envelope” scenarios and were never meant “to be portrayed as precise”.

And hey, this may be related — In 2005, Allison reported that he had received funding from 148 drug and diet industry sponsors.

It’s weird how that always happens.

Paul Campos thoroughly examines and debunks the 1999 Allison study in The Obesity Myth.

In his critique of Allison’s study, Glenn Gaesser has pointed out that because studies have repeatedly shown that there is no link between a higher BMI and death in people over 65, that those people should be excluded from any claims about death due to fatness.

78 percent of the 2.3 million annual deaths in America are people over the age of 65. So that leaves about 500,000 deaths in people under 65 that might be related to fatness.

Excluding all other forms of death — accidents, the flu, homicide and suicide, pollution, et cetera — 60% of all deaths in people under 65 would have to be caused by fatness.

This is a flatly ridiculous and unbelievable claim.

Allison’s study from 1999 is pretty clear about how they arrived at their numbers.

“Our calculations assume that all (controlling for age, sex, and smoking) excess mortality in obese people is due to their adiposity.”

Allison and his co-authors did not investigate anything about fat people. They didn’t even mention the harms caused by dieting, medical discrimination, social stigma, diet drugs or anything else that is commonplace among fat people, much less try to control for those factors.

They discovered that fat people die from being fat by just assuming it.

Get hit by a car while fat? Well, it’s not the car that killed you! It’s the FAT.

This is appallingly bad and not even worthy of the title of scientific study.

In 2004, the Centers for Disease Control embarrassed itself with a similarly shoddy study. In March of 2004, the CDC released a report at a huge news conference stating that fatness kills 400,000 Americans a year. They claimed that fatness was about to become the number one reason of preventable death in America, which resulted in screaming media coverage that fatness was a self imposed death sentence.

In May of 2004, however, Science magazine dug into the statistics, reporting that there was doubt about these numbers, including from people who worked at the CDC. According to the article, those researchers “dismiss this prediction, saying the underlying data are weak. They argue that the paper’s compatibility with a new anti-obesity theme in government public health pronouncements — rather than sound analysis — propelled it into print.”

And in November of 2004, the Wall Street Journal published a front page story about the errors in the CDC’s study. The reporting noted that the study “inflated the impact of obesity on the annual death toll by tens of thousands due to statistical errors … Dr. Pechacek (a scientist at the CDC) wrote to colleagues that he had warned two of the paper’s authors, as well as another senior scientist. (He said) ‘I would never clear this paper if I had been given the opportunity to provide a formal review’.”

I’m just going to quote a little more from the Wall Street Journal article, because it’s genuinely astonishing how blatant these hucksters are.

“Dr. Gerberding (the director of the CDC) in an interview yesterday, acknowledged that there had been human errors in the study’s calculations, but said they don’t diminish the threat that obesity causes to public health. “The bottom line is that obesity is a leading cause of death,” Dr. Gerberding said. “This paper in and of itself is a very minor contributor to our knowledge of obesity.”

It doesn’t seem very minor, when people are still citing the CDC’s support for fake death statistics as a reason for why it’s ok to harm and discriminate against fat people.

Seeing as the Centers for Disease Control is a major part of the public health wing of the American government, and as such, helps set public health policy for not only the United States but around the world — the fact that they ignored their own scientists to put out made up numbers that only exist to help the weight loss industry — that seems like a major issue and big deal to me.

And in January of 2005, the CDC admitted that its study was wrong and that the 400,000 annual deaths figure had been exaggerated due to mathematical errors.

The massive revising downward of estimated deaths from fatness did not receive the same coverage as the wildly inflated numbers, and have not in any way made the same impact as the original study. The statistics were essentially retracted but their impact remains.

As of March 2018, according to the Journal of American Medicine website, the original, fake CDC numbers have been cited 2,846 times, while the correction has only been cited 326 times.

That seems fairly major.

Is it a coincidence that the director of the CDC, Dr. Gerberding, orchestrated a splashy press conference with faked up death statistics just days before she was scheduled to appear before Congress to ask for more money for her agency?

A study that she prepared herself, in a field that she had no expertise in, that did an end run around her own in-house scientists?

Doesn’t seem like a coincidence to me.

And of course, even after the CDC had to retract their wildly overblown so-called study, they still published a statement that said, as quoted in Health at Every Size by Linda Bacon-

“Despite the recent controversy in the media about how many deaths are related to obesity in the United States, the simple fact remains: obesity can be deadly.”

Translation — let’s not let the facts get in the way of a good con.

Remember what Harriet Brown said in Body of Truth —

“I’ve been told by numerous researchers that the easiest way to get a study funded now is to include the word ‘obesity’ in the proposal. Even better, cite ‘childhood obesity’.”

And now it seems like a great time to introduce the concept of regulatory capture, as developed by University of Chicago economist George Stigler.

Regulatory capture is when the government agencies that are supposed to regulate industries actually serve the interests of those industries rather than the public interest.

Under capitalism, the government tends towards regulatory capture, just like how under capitalism, industries tend to form monopolies to maximize profit.

The history of the Food and Drug Administration is a history of regulatory capture, of a government agency that is supposed to be working for the good of public health, instead being hollowed out and repurposed to serve the interests of the pharmaceutical industry.

When the Republicans took over the House in 1994, they were out for the FDA’s blood. Under Newt Gingrich’s tenure as Speaker of the House, many of the FDA’s activities were privatized. Gingrich would even personally intervene in FDA decisions, pushing for the approval of drugs owned by companies who had contributed to his foundation.

In 1991, the FDA had drawn up a list of 111 ingredients used in non-prescription diet ads and declared them ineffective or unsafe. This would have been quite a blow for the weight loss and supplements industry, but don’t worry. Republicans took care of it.

In 1994, the Dietary Supplements Health and Education Act made it almost impossible for the FDA to continue regulating these products. This law was pushed through by Senator Orrin Hatch, a Republican Senator from Utah, where the herbal supplement industry is huge.

Instead of the manufacturers having to prove that their supplements are safe, now the FDA has to bear the burden of paying for an investigation to prove that these products are unsafe.

Alicia Mundy says in Dispensing with the Truth-

“Officials now spoke of the pharmaceutical industry, not the American public, as ‘our clients’. Pharmaceuticals were playing hardball like doctors at the FDA had never seen before, backed by Congress. The FDA had to accede to the new culture, or its budget would be decimated.”

Republicans even attempted to get rid of the FDA completely in 1994. While they were not successful in that attempt, the FDA’s budget has been cut again and again, while the balance is made up by “user fees” which are paid by the drug companies to the FDA for drug approval.

Add in the revolving door of officials at the FDA who leave the agency for lucrative jobs with the drug companies they are supposed to be overseeing, and you can see that the agency is ripe for exploitation by the very industry it is supposed to be regulating.

Multiply and repeat this same tactic over the other government agencies that are supposed to be advocating for public health, and you can see how we are getting fake numbers from the Centers for Disease Control, and changes in BMI standards that only benefit the weight loss industry from the National Institutes of Health.

And that’s the end of our review of the death statistics.

Please see the notes for a list of the sources I consulted for this series.

All my love and thanks to all the fat activists around the world — past, present and future — who are doing such amazing and fantastic work.

And thank you to all my supporters on Patreon, especially these lovely people — you make it all possible, and I love you for that!!

You can support my work on Patreon at patreon.com slash Ok2BeFat or you can make a one time donation at ko-fi.com slash Bad Fatty Ali

See you again soon!

—

Sources-

-Public Health Profiteering by James T. Bennett & Thomas J. DiLorenzo

-Dispensing with the Truth by Alicia Mundy

-The Fat Studies Reader, edited by Esther Rothblum and Sondra Solovay; “Prescription for Harm- Diet Industry Influence, Public Health Policy, and the ‘Obesity Epidemic’.” by Pat Lyons.

-“Actual causes of death in the United States” by McGinnis JM, Foege WH.

Journal of the American Medical Association, 1993 Nov 10

https://www.ncbi.nlm.nih.gov/pubmed/8411605

-“Methods of Calculating Deaths Attributable to Obesity” by Katherine M. Flegal, Barry I. Graubard, David F. Williamson; American Journal of Epidemiology, Volume 160, Issue 4, 15 August 2004, Pages 331–338 http://aje.oxfordjournals.org/content/160/4/331.long#ref-5

-The Obesity Myth by Paul Campos

-“CDC Study Overstated Obesity as a Cause of Death”, Wall Street Journal, by Betsy McKay, Nov. 23, 2004

http://www.wsj.com/articles/SB110117970881981681

“Obesity: An Overblown Epidemic?”, Scientific American, by W. Wayt Gibbs on December 1, 2006

https://www.scientificamerican.com/article/obesity-an-overblown-epidemic-2006-12/

“Annual Deaths Attributable to Obesity in the United States”; Journal of the American Medical Association, October 27, 1999

David B. Allison, PhD; Kevin R. Fontaine, PhD; JoAnn E. Manson, MD, DrPH; et al

https://jamanetwork.com/journals/jama/fullarticle/192032

“Regulatory and academic capture”, The Washington Post, By Will Baude, May 18, 2014

https://www.washingtonpost.com/news/volokh-conspiracy/wp/2014/05/18/regulatory-and-academic-capture/?utm_term=.5467df01d7a4

Newt Gingrich: Capitol Crimes and Misdemeanors

By John K. Wilson

https://books.google.com/books?id=0jUA65oCqrIC&pg=PA9&lpg=PA9&dq=newt+gingrich+fda+1994&source=bl&ots=Moxroo4qLK&sig=_mZL5fBNGtktzhBBE2wUeCDXThc&hl=en&sa=X&ved=0ahUKEwiD3OiBxfPOAhWDJCYKHQrNC18Q6AEIKDAC#v=onepage&q&f=false

Losing It- America’s Obsession with Weight and the Industry that Feeds on It by Laura Fraser

“Stupid Pills: The Politics of Fraudulent Dietary Supplements”, The New York Times, by Timothy Egan, February 6, 2015

https://www.nytimes.com/2015/02/06/opinion/the-politics-of-fraudulent-dietary-supplements.html

“Actual Causes of Death in the United States, 2000”; Journal of the American Medical Association; March 10, 2004

Ali H. Mokdad, PhD; James S. Marks, MD, MPH; Donna F. Stroup, PhD, MSc; Julie L. Gerberding, MD, MPH

https://jamanetwork.com/journals/jama/article-abstract/198357?resultClick=1&redirect=true

“Correction: Actual Causes of Death in the United States, 2000”; Journal of the American Medical Association; January 19, 2005

Ali H. Mokdad, PhD; James S. Marks, MD, MPH; Donna F. Stroup, PhD, MSc; Julie L. Gerberding, MD, MPH

https://jamanetwork.com/journals/jama/article-abstract/200177?redirect=true

Health at Every Size by Linda Bacon PhD

BMI part 3- The evidence against BMI- Transcript

Hi, everyone, it’s Ali from Ok2BeFat! And it’s time for some fat activism basics.

In this series of videos, I’ll be talking about BMI, or the body mass index.

If you haven’t watched part 1 & 2 yet, I suggest you go back and watch them now, so we’re all on the same page.

Ready? Great!

This is Part 3. The evidence against BMI.

In this video I will be discussing weight and weight loss. I will also be using the words “obesity” and “overweight” in the context of discussing and quoting scientific studies, even though these are not words I would normally use.

Before we start talking about debunking BMI and the evidence against it, let’s make sure we all have the same definitions.

Epidemiology is the study of how often diseases occur in different groups of people. When we discuss the scientific studies that are supposed to show how many fat people are dying and of what, the scientific field we are talking about epidemiology.

Epidemiologists research fatness by comparing groups of fat people to groups of thin people and cataloging the differences. These studies can give us correlations — show us that two things may be connected — but they can’t show causation, which is that one thing causes another.

Linda Bacon gives a good example of this in Health at Every Size. Her example is that balding men have been shown through epidemiology to have higher rates of heart disease than men who haven’t lost their hair.

Does this mean that the amount of hair on your head protects you from heart disease? It is recommended that bald men get toupees to reduce their risk of heart disease?

Not at all.

Further research showed that higher levels of testosterone may be causing both baldness and heart disease.

So when people talk about these studies, it’s incredibly important to keep in mind that correlation does not equal causation.

Or that because A and B are happening at the same time, that doesn’t mean that A caused B. B could be causing A. Or C and/or D could be causing them both.

And studies that show correlation may not apply to every individual person. Not everyone with high testosterone will lose their hair or have heart disease.

And while there are diseases that are associated with fatness, an association doesn’t prove a cause.

For example, in type 2 diabetes, research shows that the insulin resistance that eventually develops into type 2 diabetes may cause weight gain, not that gaining weight causes insulin resistance.

People like to talk as though simply being fat causes heart disease or diabetes, but there are no diseases that can be attributed simply to fatness. Because there are no diseases that only fat people get that thin people don’t.

In addition, when discussing rates of harm and death of fat people, we must always keep in mind that fat people are pushed into high risk weight loss methods, including medication with harmful or deadly side effects and dangerous and sometimes deadly surgery to mutilate their functional organs.

The cycle of repeatedly gaining and losing weight through yo-yo dieting is very dangerous. Just one instance of losing and then gaining back weight can damage blood vessels and increase the risk of cardiovascular disease.

It’s also important to keep in mind that fat people face significant medical discrimination and that medical personnel have repeatedly shown very high rates of both implicit and explicit anti-fat bias.

I’ve included two examples of the many studies into the issue of rampant fat bias in medical personnel in the sources list, one is called “Implicit anti-fat bias among health professionals: is anyone immune?” by B A Teachman and K D Brownell and the other is “Implicit and Explicit Anti-Fat Bias among a Large Sample of Medical Doctors by BMI, Race/Ethnicity and Gender” by Janice A. Sabin, Maddalena Marini, and Brian A. Nosek.

I also suggest “First, Do No Harm- Real Stories of Fat Prejudice in Health Care”, a series of first hand stories by fat people of the prejudice and harm they face at the hands of the medical profession. You can find a link in the source notes.

When faced with humiliation, scorn, and gatekeeping at the doctors office, many fat people choose not to go. And when they do go, they are often belittled, mocked and denied care.

Any study that discusses the health and mortality rates of fat people that doesn’t take these factors into consideration is basically worthless.

Now that we set up a proper framework, let’s dig into the studies.

In 2005, epidemiologist Katherine Flegal published a study in the Journal of the American Medical Association titled “Excess deaths associated with underweight, overweight, and obesity”.

In this study, she confirmed what Ancel Keys had found in the 1980s, that the risks of premature mortality associated with BMI actually forms a U-shaped curve, indicating increased risk for very underweight people as well as very overweight people.

Additionally, where death rates did go up, it wasn’t by much. In Harriet Brown’s book Body of Truth, Flegal called the differences “pretty tiny”.

This study was met with a complete uproar. The experts insisted there was no way these results could be trusted, that Flegal’s work was poor. They accused her of cherry picking data.

An epidemiologist from the University of Illinois-Chicago, S Jay Olshansky, replied to Flegal’s study with a journal article arguing that rising rates of fatness would shorten overall lifespans by between 2 and 5 years.

This was completely made up, as Olshansky’s co-author, David Allison, would later admit to Scientific American, saying that the prediction was never meant to be portrayed as precise.

That kills me. Why did you have it published then, dude? I guess because fear mongering is profitable?

So Flegal takes a look at the uproar and the criticism and decides to rebut it by spending the next 8 years collecting information about 97 different studies on weight and premature mortality.

The results of this meta-analysis, which was published in 2013 and included results from over 2.88 million people, were exactly the same as the results of the 2005 study.

Being fat does not put a person at greater risk for dying, and even being very fat only increases the chances slightly.

This second study provoked another round of denial and uproar. One of Flegal’s loudest critics has been Walter Willett, a nutritionist and professor at Harvard. He even organized a conference at Harvard solely to attack her work.

Selectively choosing which data to include is Willett’s criticism of Flegal, which is funny since the 2010 study that he published — the one that found early mortality risks the lowest among people with so-called ‘normal’ BMI — that study threw out over 80 percent of the data to get to that status quo upholding result. He deleted anyone who had ever smoked or had any history of cancer or heart disease.

So who picked the cherries here? Exactly?

I guess we’ll never know. Oh look, I’ve died from sarcasm poisoning.

In his book The Obesity Myth, Paul Campos discusses another famous study that is supposed to prove that a higher BMI leads to higher premature mortality.

The Nurse’s Health Study was published in the New England Journal of Medicine under the title “Body Weight and Mortality Among Women”. It followed 115 thousand nurses for 16 years. And although this study is cited constantly as proof that fatness kills, it has major flaws.

For one thing, only 4 thousand 7 hundred women died in this time period out of 115 thousand, or about 4.5% of the group.

This is not a very large number of deaths, and not really a percentage that should allow people to feel confident making sweeping statements about so-called excess weight being a danger to all people everywhere.

98% of this group of nurses was middle-aged, middle-class, white American women.

So maybe the safest thing we can say about this study is that middle class white women have really low overall mortality when they are middle-aged.

We could also safely say that smoking is a serious health hazard, as the death rate was significantly higher among smokers.

Because the thinnest women were nearly twice as likely to smoke as the fattest women, we could perhaps even say that wanting to stay thin is a risk factor for smoking.

A side note —

I am an ex-smoker and I don’t like the demonizing of smokers that you see basically everywhere. So let’s lay off turning people who smoke into demons. Rates of smoking are higher among marginalized groups and quitting is a painful daily agony with very little in the way of support.

Smoking is legitimately bad for you, but so is playing football or driving a car.

I will not turn one group of people into monsters to save another. People are people and we’re all doing the best we can.

So let’s not go there, ok? Great, thank you.

Back to Campos — The authors of the Nurse’s Health Study used percentages in misleading ways.

To give an analogy of the way the data was manipulated, consider this example,

if an overall 2% risk of rain is doubled to 4%, that’s still a quite small chance that it will rain.

You can either report an overall 2% increase in risk, or you can say the risk went up by 200%. Both are factually accurate, but the second one looks much scarier and bigger simply because 200 is a bigger number.

If you take out such manipulations of data, the Nurse’s Health Study actually finds that the women with the lowest risk of death are a lot larger than average.

And yet, the authors of this study claimed that being even mildly overweight is associated with a substantial increase in premature death, a conclusion which their own study does not support.

This disconnect between the data and the conclusions of a study are very common in studies that are supposed to prove negative claims against fat people.

When you take these fatphobic study conclusions, turn them into a press release that you run through the media machine of science reporters who report only screaming headlines, you add more stigma to a world that never stops harming and stigmatizing fat people.

Let’s add a few more studies, a bit more research for the “But Science” crowd, just to make sure we all know that studies debunking BMI and lifespan are very widespread.

In Health at Every Size, Linda Bacon lists the following studies that show that fat people were living as long as, and frequently longer than, so-called normal weight people.

The Established Populations for the Epidemiological Studies of the Elderly investigation which included more than 8 thousand senior citizens.

The Study of Osteoporotic Fractures investigation which included more than 8 thousand women.

The Cardiovascular Health Study which included almost 5 thousand people.

The Women’s Health Initiative Observational Study which included 90 thousand women

A study of almost 170 thousand people in China

A study of 20 thousand German construction workers

A study of 12 thousand Finnish women

A study of 1.7 million Norwegians, which found the lowest life expectancy among those defined by BMI as underweight.

And what has the scientific community done when faced with this research?

They label it a paradox and ignore it. They keep pushing outdated information. They actively work to keep the stigma against fat people in place, a stigma that ruins lives.

Because supporting the status quo is easy. And because that’s how so many of them get paid.

Harriet Brown says in Body of Truth- “I’ve been told by numerous researchers that the easiest way to get a study funded now is to include the word ‘obesity’ in the proposal. Even better, cite ‘childhood obesity’.”

So when faced with the question — why do we keep using BMI as a measurement of health when we know it doesn’t measure health at all? — I think the answer is clear.

BMI does actually do what it’s supposed to do. It’s just that what it is supposed to do has nothing to do with health.

BMI is a way to excuse the bigotry that is fatphobia.

BMI gives fatphobia rules. It makes hating fat people easy and bloodless. It keeps the worst and most deadly discrimination we face — medical discrimination — it keeps that discrimination discreet and private and hard to talk about or to prove.

BMI gives a culture than hates and fears fatness a science-y sounding basis to keep hating and fearing fat people. To keep hating and punishing the fat people that thin people are afraid they are going to become.

BMI makes stigmatizing fat people easy. It uses math and round numbers to put a little distance between the fatphobic person and the fat person they are harming.

BMI makes a fat person into a number, a medical problem, a disease that must be stopped by stripping fat people of our status as people and replacing our humanity with a moral indictment in the form of an equation.

BMI props up the weight loss industry, a harmful and useless industry that extracts $60 billion dollars a year out of the economy of the United States — money that it would not be possible to make without fat stigma. Money that could be put to better use doing almost anything else.

The profits of this agony machine are increased by increasing the pain and fear and deaths of fat people.

BMI makes hatred into math. And people feel comforted in their prejudice by having that math. And some people make obscene amounts of money from it. And so it remains.

But it doesn’t have anything to do with heath and it never did.

And that’s the end of Part 3! And the end of the BMI series.

Please see the notes for a list of the sources I consulted for this series.

If you have specific questions about BMI, leave a comment below!

Always and forever, I have to thank all the fat activists who came before me and those who will come after.

And thank you also to my supporters on Patreon, especially the ones scrolling by now.

You can support my work on Patreon at patreon.com slash Ok2BeFat. Your support helps me continue this work. See you again soon!

—

Sources —

Adolphe Quetelet and the Evolution of Body Mass Index (BMI) — by

Sylvia R. Karasu M.D.

https://www.psychologytoday.com/blog/the-gravity-weight/201603/adolphe-quetelet-and-the-evolution-body-mass-index-bmi

Beyond BMI — by Jeremy Singer-Vine

http://www.slate.com/articles/health_and_science/science/2009/07/beyond_bmi.html

Commentary: Origins and evolution of body mass index (BMI): continuing saga — by Henry Blackburn and David Jacobs, Jr

https://academic.oup.com/ije/article/43/3/665/2949550/Commentary-Origins-and-evolution-of-body-mass

NIH statement- “Health Implications of Obesity”

https://consensus.nih.gov/1985/1985Obesity049html.htm

Implicit anti-fat bias among health professionals: is anyone immune? — by B A Teachman and K D Brownell

http://www.nature.com/ijo/journal/v25/n10/full/0801745a.html

Implicit and Explicit Anti-Fat Bias among a Large Sample of Medical Doctors by BMI, Race/Ethnicity and Gender — by Janice A. Sabin, Maddalena Marini, and Brian A. Nosek

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0048448

First, Do No Harm- Real Stories of Fat Prejudice in Health Care

https://fathealth.wordpress.com/

The big fat truth — by Virginia Hughes

https://www.nature.com/news/the-big-fat-truth-1.13039

Tobacco Use Among Adults with Mental Illness and Substance Use Disorders

https://www.cdc.gov/tobacco/disparities/mental-illness-substance-use/index.htm

Body of Truth by Harriet Brown

Losing It by Laura Fraser

Big Fat Lies: The Truth about Your Weight and Your Health by Glenn A Gaesser, PhD

The Obesity Myth by Paul Campos

The Great Starvation Experiment by Todd Tucker

Fat History by Peter N. Stearns

Health at Every Size by Linda Bacon, PhD

—

Ok2BeFat logo art by Jen Lightfoot (http://www.jenlightfoot.com/)

The Fat Activism Basics, BMI part 2- Transcript

BMI part 2- the history of BMI.

Hi, everyone, it’s Ali from Ok2BeFat! And it’s time for some fat activism basics.

In this video I will be discussing weight and weight loss. I will also be using the words “obesity” and “overweight” in the context of discussing and quoting scientific studies, even though these are not words I would normally use.

In this series, I’ll be talking about BMI, or the body mass index.

If you haven’t watched part 1 yet, I suggest you go back and watch it now, so we’re all on the same page.

Ready? Great!

This is Part 2. The history of BMI.

Fatness wasn’t always considered bad. Around the end of the 1800s, there was a negative shift in cultural attitudes towards fat people, when before that time fatness had been fashionable and had even been celebrated.

Until the 1890s fatness was very fashionable, especially among women. The Victorian ideal for a woman was of a mother at home in her proper place with her children. Fatness was viewed as a natural consequence of frequent pregnancies and frequent pregnancies were very much to be desired.

According to Peter Sterns in Fat History, Elizabeth Cady Stanton was praised for her round features, approvingly called “as plump as a partridge” while her fellow suffragette Susan B. Anthony was criticized for being gaunt and too thin.

Doctors urged weight gain for a number of nervous disorders, and actresses were praised for their fashionably rounded arms and faces. For men, fat bodies were socially read as belonging to men with fat bank accounts and both a fat body and a fat wallet were to be desired.

There are a lot of factors that play into the cultural slide towards the demonizing of fat, but in Big Fat Lies Glenn Gaesser points to the life insurance industry as one of those factors.

In order to make as much profit as possible, life insurance companies were looking for ways to separate people into higher and lower risk categories for premature mortality. They needed a way to try to predict if someone has a higher chance of dying early.

A side note-

Generally when we are talking about mortality rates in the context of fatness, what we mean are people dying early, where early is considered to be before 65 years old, because in the United States 78% of all deaths are of people who are over the age of 65.

It’s important to make sure that everyone knows we are talking about premature mortality even when people leave out the word “premature”, otherwise you get people who say things like “all fat people are going to die” without seeming to grasp the idea that all the thin people are also going to die because being thin does not make you immortal.

So you have life insurance companies in the 1890s trying to figure out who might die early because they want to take in more insurance policy payments than they pay out in claims when someone dies. Because that is how insurance companies make money.

This is way before the type of data collection we have today. In the 1890s and well into the 1900s, the insurance companies didn’t have access to hardly any information about their policyholders. But what they did have was weight- public scales for weighing began to appear in 1891.

Because weight is such an easy figure to collect and track, the industry took this information and tried to match it up to its policyholders to see if there was any correlation to premature death.

This gives us the first height-weight tables in the 1890s, with the assumption that anything over the average weight was bad and contributed to premature mortality.

But how did the insurance companies collect and interpret this data? Does it hold up to scientific standards? Well, no.

The two largest examinations undertaken by these insurance companies were riddled with flaws. These studies are the 1959 Build and Blood Pressure Study and the 1979 Build Study.

For one thing, the demographics of life insurance policy holders did not accurately represent the population at large, because the people paying for life insurance are richer and whiter and more male than the general population.

But even worse, the insurance companies defined mortality for their purposes as a policy being cashed in, and not as we would usually define it — as the death of a single person. If someone purchased 5 insurance policies, his death would count 5 times, which skews the actual sample size.

And even though the studies are meant to cover a large range of time —

1935 thru 1954 for the first study and 1954 thru 1972 for the second — these studies do not measure a fixed population over a fixed period of time. A person who bought a policy in 1936 and someone who bought one in 1952 would both be included in the 1959 study, which is a ridiculous oversight for a study purporting to measure longevity.

But for years, these unscientific height and weight tables from life insurance companies were used to determine who was supposedly too fat.

In 1972, Ancel Keys sought to displace the by now discredited life insurance tables with something more scientific. And for that, he turned to a formula originally authored by in 1832 by Adolphe Quetelet, a Belgian mathematician who came up with the equation we now call BMI.

Quetelet was something of a Renaissance man, with interests in various arts and sciences. He spoke six languages. He was fascinated by astronomy, founding the Brussels Observatory and serving as its director for 50 years.

But his true love was statistics. He loved gathering and studying data on large groups of people, believing that there was fundamental truth to be found in the study of these large groups, rather than focusing on the experiences of any one person.

He wanted to quantify the average man. But to Quetelet, average didn’t mean boring or mediocre — average was the definition of perfection. In his book, A Treatise on Man and the Development of his Faculties, Quetelet says —

“If the average man were completely determined, we might consider him as the type of perfection; and everything differing from his proportion or condition, would constitute deformity or disease…or monstrosity.”

Quetelet was not studying fatness or health in any of the ways we would talk about today. Rather, he was interested in what constituted an average size over a population.

It also seems important to mention that the population that led to the original BMI calculation was a few hundred residents of Brussels — not exactly a group representative of the population of the entire world.

For a long time, the Quetelet equation was known to a few scientists but it didn’t go much further than that.

Then, in 1972, Ancel Keys published a study of over 7,400 men from 5 different countries called “Indices of Relative Weight and Obesity” that concluded that Quetelet’s index was the best indicator of the extent of body fat of an individual person. Keys is the one who named the calculation the body mass index.

This study popularized BMI and in 1985, the National Institute of Health began using it as a way to define obesity.

A side note —

This is the part where I tell you that Ancel Keys is kind of a mixed bag for fat activism. He conducted the Minnesota Starvation Experiment, which has findings that are frequently cited by fat activists regarding the dangers of yo-yo dieting, as well as the mental toll a continued calorie deficit can have.

Keys clearly didn’t intend for BMI to be used as an indicator of individual health. He conducted a review of the major studies on fatness and premature mortality in 1980 that found a risk of premature mortality increased in both underweight and overweight people, but only at the very extremes.

But Keys also called fatness “disgusting as well as a hazard to health” and “ethically repugnant”. He became obsessed with the idea that an overconsumption of dietary fat caused heart attacks, and it has been suggested that his study into fat consumption played fast and loose with the data — specifically that he only included the results that confirmed his original hypothesis.

He also made an enormous amount of money off of one of the first low fat cookbooks “Eat Well and Stay Well”. His conclusions were used by the US Senate to set national nutrition standards that helped set off the low-fat dieting craze that began in the 1970s.

Is it possible that the overlap of a period of time of national emphasis on high carbohydrate and low fat meals and a period of time when overall weight levels appear to have increased may mean that the one has caused the other?

Well, it’s certainly possible, but we don’t know. There may not be a way to ever know for sure, based on the large number of variables present in such a question, but it does present an interesting counter narrative that has yet to be fully explored.

It certainly seems that for Doctor Keys, somewhere along the way, the amount of dietary fat consumed by a population got conflated with the perceived number of fat people in a given population. He just assumed that the existence of fat people was caused by consuming fat.

Some of the assumptions Keys originally made are ones that we still see playing out today, in ways that harm fat people.

Back to the timeline-

In 1985, the National Institutes of Health officially took up BMI as the standard way to measure obesity, while acknowledging that the data on fatness and premature mortality was disputed and sometimes contradictory. The statement they put out notes that perhaps the greatest suffering caused by fatness is the “enormous psychological burden” it causes.

You’ll have to excuse me for finding some bitter amusement in that. A document that helped to advance fatphobia by making BMI the tool to mark who is too fat — a tool that is used every day, around the world to discriminate against fat people in medical settings to devastating and often deadly consequences — that this document would hand wave concern in the direction of the mental suffering of fat people?

It seems almost beyond belief.

Back to 1985 — the NIH meeting to adopt the new BMI standards included people with ties to the weight loss industry.

We’ll find as we go on that just about any conference to discuss fatness as a medical problem always includes representatives of the weight loss industry, an industry that makes billions each year off of the “enormous psychological burden” they help cause.

The standards set by the National Institutes of Health in 1985 put overweight at a BMI of 27.8 for men and 27.3 for women.

Then in 1998, the NIH went back to BMI again and changed the standards to 25 for overweight and added a new category for obese, which began at 30.

This change consolidated the prior two standards into one for all genders, races and ages, even though the ability of BMI to predict body fat is not consistent among genders or among people of different races, or at different ages.

Many people who would have been considered an average weight were pushed into the overweight range overnight.

The only peer reviewed research the 1998 Obesity Task Force cited in their recommendation to lower the BMI cutoffs was a study that suggested that raising the overweight cutoff to 40 would be more in line with the actual research.

Let me repeat that, because I want to make sure we all heard it properly.

The task force that lowered the BMI standards in 1998 — the only peer reviewed research they included in their report recommending that the cutoffs for a so-called ‘normal’ weight category be lowered — that study recommended that the cutoffs be raised and raised significantly. To a BMI of 40.

Not lowered. Raised. And yet the standard was lowered anyway. Why?

Well, 7 of the 9 participants in the NIH’s 1998 Obesity Task Force were directors of weight loss clinics, while also having multiple other financial ties with the weight loss industry as a whole.

The change to a more stringent standard obviously served to benefit that industry, by making more people subject to dire health warnings from their doctors.

And that brings us up to the present day.

More fear means more money. Inducing a moral panic over fatness, ramping up fatphobia, hurting fat people — this is huge money for the weight loss industry.

The weight loss industry has continued to use the lowered cutoffs to turn enormous profits. They turn agony into cash, 60 billion dollars worth, every year, just in the United States alone.

And that’s the end of Part 2- the history of BMI.

Please see the notes for a list of the sources I consulted for this series.

If you have specific questions about BMI, leave a comment below!

Always and forever, I have to thank all the fat activists who came before me and those who will come after.

And thank you also to my supporters on Patreon, especially the ones scrolling by now.

See you soon for part 3.

—

Sources —

Adolphe Quetelet and the Evolution of Body Mass Index (BMI) — by

Sylvia R. Karasu M.D.

https://www.psychologytoday.com/blog/the-gravity-weight/201603/adolphe-quetelet-and-the-evolution-body-mass-index-bmi

Beyond BMI — by Jeremy Singer-Vine

http://www.slate.com/articles/health_and_science/science/2009/07/beyond_bmi.html

Commentary: Origins and evolution of body mass index (BMI): continuing saga — by Henry Blackburn and David Jacobs, Jr

https://academic.oup.com/ije/article/43/3/665/2949550/Commentary-Origins-and-evolution-of-body-mass

NIH statement- “Health Implications of Obesity”

https://consensus.nih.gov/1985/1985Obesity049html.htm

Implicit anti-fat bias among health professionals: is anyone immune? — by B A Teachman and K D Brownell

http://www.nature.com/ijo/journal/v25/n10/full/0801745a.html

Implicit and Explicit Anti-Fat Bias among a Large Sample of Medical Doctors by BMI, Race/Ethnicity and Gender — by Janice A. Sabin, Maddalena Marini, and Brian A. Nosek

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0048448

First, Do No Harm- Real Stories of Fat Prejudice in Health Care

https://fathealth.wordpress.com/

The big fat truth — by Virginia Hughes

https://www.nature.com/news/the-big-fat-truth-1.13039

Body of Truth by Harriet Brown

Losing It by Laura Fraser

The Obesity Myth by Paul Campos

The Great Starvation Experiment by Todd Tucker

Fat History by Peter N. Stearns

Health at Every Size by Linda Bacon, PhD

—

Ok2BeFat logo art by Jen Lightfoot (http://www.jenlightfoot.com/)

The Fat Activism Basics, BMI part 1-- Transcript

BMI series- Introduction- Part 1

Hi, everyone, it’s Ali from Ok2BeFat! And it’s time for some fat activism basics.

In this series of videos, I’ll be talking about BMI, the body mass index.

I wasn’t originally going to cover this topic. Because it’s almost too basic.

Because everyone knows that BMI is a bad tool that is misused to stigmatize people. Because we all know that BMI is garbage. Right?

Well, it turns out — not everyone does know that. And talking about the problems with BMI is a foundation we need to build on, so that later we can get into more complicated topics.

We have to talk about BMI, because BMI is a critical part of the framework used to dehumanize fat people. The BMI formula plays an important role in claims that fat people have to be harmed and discriminated against because Science!

One of the most important things I’ve learned as a fat activist is that framing is key to talking about any issue. The current framework for fat people positions us as subhuman. And it’s important to never accept that a framework that dehumanizes you.

What do I mean by framing? I mean the baseline assumptions we all agree to before engaging in a dialogue.

The current mainstream dialogue around fatness is that fat people are morally degraded and that anything that makes a fat person thinner is worth it, no matter the cost. And like all dialogues, this one is based on a number of unquestioned assumptions.

Assumptions like being fat is inherently bad. That it’s possible to make fat people permanently thin. That when society holds up one end of the body size spectrum as good and the other as bad — that there are good reasons for this, rather than just outright discrimination.

I don’t accept any of these assumptions. When factual claims are made against fat people — that for example, fatness causes early death or that it is possible to make all fat people permanently thin — those claims don’t actually hold up when they are

investigated.

Without their dubious claims of scientific backing, all that fatphobic people are left with is a mish-mash of weird moralizing and transparent bigotry.

So let’s start digging into these so-called facts and see what we can find.

Starting with BMI.

In this video I will be discussing weight and weight loss. I will also be using the words “obesity” and “overweight” in the context of discussing and quoting scientific studies, even though these are not a words I would normally use.

Body size is not a disease. The word “obesity” treats larger bodies as though their very existence is a problem that needs solving.

A side note —

Somehow it seems like thin people got this idea that “obese” was a more polite term that fat, and it just isn’t. Most fat or plus size people have a real cringe response to that word. It would be super cool if you could listen to us when we explain how we’d like to be referred to. Thanks.

Just thought you might want to know.

This series about BMI is broken into 3 parts — The introduction, which is the video you’re watching right now, the history of BMI, and the research and evidence against BMI.

BMI- What is it?

BMI stands for body mass index. It is a formula originally authored by in 1832 by Adolphe Quetelet, a Belgian mathematician.

The equation used for BMI is weight in pounds, divided by height in inches squared, times 703, where the 703 calculation is used to convert the imperial measurements into metric ones.

When you do this calculation, you get a nice round number that you can place on a graph. At current guidelines, a number over 25 falls into the category of overweight and a number over 30 is considered obese. Obese being defined a level of overweight considered medically dangerous.

And it all seems so very scientific. Why, there’s even math involved!

How could you argue with that? I mean, it’s not like anyone has ever used math or statistics to lie before.

Am I saying BMI is used to lie? Yes. That’s exactly what I’m saying.

For starters, this neat round number doesn’t take race, gender, or activity levels into consideration, or income levels, disability, and other factors.

BMI is currently an arbitrary number that we use to separate people into Worthy and Unworthy, Good and Bad, Moral and Immoral categories. But BMI gives us no useful information about individual people.

BMI is even worse than simply being useless, because it actively promotes incorrect assumptions that can lead to poor medical outcomes and the advance of fat stigma.

BMI prevents us from using the real medical tools that would tell us something about people’s actual health by tricking doctors and other authority figures into thinking they have information about people that they actually… don’t.

I’m not sure why in the 21st century, we are still relying on “that person looks weird” as a medical diagnostic tool, rather than something like a blood test or an X-ray, or looking in people’s ears with that weird pointy ear thing.

Why should we be using a formula from 1832 as a medical tool? A tool proposed by a man who wasn’t a doctor, from a time before people accepted that germs exist, and from before we knew about viruses. In the 1830s people were taking cocaine for their allergies and using heroin in their cough syrups.

You would think we’d really advanced in the years since, but the way we look at fat people is stuck with a pre-modern equation that basically amounts to asking a magic 8-ball to tell you who the bad people are.

When you can measure people’s blood pressure, you don’t have to assume what it is by looking at them. That seems like it should be the point of having machines and tests that measure things.

As we look into the history of how the BMI equation was formed, we are going to find even more reasons to question its validity as a measurement, because it wasn’t arrived at in a very scientific manner. And it continues to be upheld against mountains of evidence that it should be dropped.

Part 2 will be an exploration of the history of BMI throughout the years since it was first proposed in 1832 up through the present day.

Part 3 will be an exploration of the evidence that BMI doesn’t match up to the premature deaths that fat people are always threatened with.

Studies, did you say? We’ve got studies.

And that’s the end of Part 1, an introduction to BMI.

Please see the notes for a list of the sources I consulted for this series.

Always and forever, I have to thank all the fat activists who came before me and those who will come after.

And thank you also to my supporters on Patreon, especially the ones scrolling by now.

See you soon for part 2.

—

Sources— Adolphe Quetelet and the Evolution of Body Mass Index (BMI)— by Sylvia R. Karasu M.D. https://www.psychologytoday.com/blog/...

Beyond BMI— by Jeremy Singer-Vine http://www.slate.com/articles/health_...

Commentary: Origins and evolution of body mass index (BMI): continuing saga—by Henry Blackburn and David Jacobs, Jr https://academic.oup.com/ije/article/...

NIH statement- “Health Implications of Obesity” https://consensus.nih.gov/1985/1985Ob...

Implicit anti-fat bias among health professionals: is anyone immune?— by B A Teachman and K D Brownell http://www.nature.com/ijo/journal/v25...

Implicit and Explicit Anti-Fat Bias among a Large Sample of Medical Doctors by BMI, Race/Ethnicity and Gender—by Janice A. Sabin, Maddalena Marini, and Brian A. Nosek http://journals.plos.org/plosone/arti...

First, Do No Harm- Real Stories of Fat Prejudice in Health Care https://fathealth.wordpress.com/

The big fat truth—by Virginia Hughes https://www.nature.com/news/the-big-f...

Body of Truth by Harriet Brown

Losing It by Laura Fraser

Big Fat Lies: The Truth about Your Weight and Your Health by Glenn A Gaesser, PhD

The Obesity Myth by Paul Campos

The Great Starvation Experiment by Todd Tucker

Fat History by Peter N. Stearns

Health at Every Size by Linda Bacon, PhD

—

Ok2BeFat logo art by Jen Lightfoot (http://www.jenlightfoot.com/)

To the fat people- an encouragement video-- Transcript

To the fat people —

It’s ok to be fat. You haven’t done anything wrong.

You deserve to have a life where you can feel proud and happy.

And I just want you to know that you are as worthy of love and friendship and care as anyone else.

I want you to know that thin people aren’t better than you. That being fat is not a moral failing.

That fat is just a size, just like thin is just a size.

I want you to know that the people who make you feel bad about your size are wrong. There’s nothing inherently wrong about being bigger.

I know that it’s hard. But I know you can be strong and I believe in you.

It’s ok to be fat. You haven’t done anything wrong.