Talk:Fat acceptance movement

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[edit] "Rejection of idealized body types."

Important stuff, and worth writing about. But I'm not sure if it belongs under the rubric of "fat activism," 'cause it seems to me like not just a few of the bodies in question fit no reasonable definition of "fat." Framing everything in terms of fat activism doesn't open up a lot of space for things like telling thin women that they need to eat a sandwich, or men being told they need to bulk up, or, the role of cosmetic surgery in marketing the ideal by putting collagen in lips and silicon in breasts and performing labioplasties so women have an appropriately porn-ready appearance. (I'm only talking about these procedures in terms of them being used to market a particular look, not medically necessary uses....)

Would it be productive to hive off stuff that's about challenging the narrow range of ideal bodies to a more general article on body image, and keep this article for a more narrow examination of the specific arguments/debates re: topics like obesity and health? Father Vivian O'Blivion (talk) 15:32, 16 June 2014 (UTC)

Is age (let's inject away the wrinkles, ladys) and de-greying part of body types, or a different issue?One tin soldier (talk) 15:38, 16 June 2014 (UTC)
It's all the same issue. I'm a thin woman, very thin in fact, although I eat healthily. And I see it as part and parcel of fat activism. Could it be you are not familiar with the body-acceptance movement? E.g., this. Which might be a better title for this whole article in fact, and we can set-up redirects. ·FemiliskSJ 15:39, 16 June 2014 (UTC)
I am quite familiar with the concept/movement. And yes, renaming this article something along those lines seems like a good idea, though the obesity-vs-health debate may eventually grow enough to warrant its own article a little later on, I reckon... Father Vivian O'Blivion (talk) 15:42, 16 June 2014 (UTC)
Yeah, the whole weight/body woo thing needs addressing as it's just another con. Firstly, we need to make the whole thing way less biased. ·FemiliskSJ 15:44, 16 June 2014 (UTC)

[edit] "Straight denialism

Since this is a major change that I propose, I'm adding it here for comments first. I propose this, instead of the unsourced sillyness currently on the page:

(header title)When body-positive goes to far

Based on what can be found on internet blogs, and posts by individuals, body-positive, like all things, can go too far. While it is important that media be cautious how it phrases health concerns, it remains equally important that news reports on real medical issues associated with having too much fat on your body. Shifting health conversations from "overweight" and "bmi" to body fat percentage begins to address this. When extremists deny [citation needed] that having a high percentage of body fat does not contribute to potential health risks, it is a dangerous message.

Body positive messages for adults have distinctly different consequences from healthy weight and pro activity messages for kids. Lindy West refA writer at Jezebel, who has studied and written extensively on body image ref said in an article on body image, that "The government is literally waging a war on fat people" ref http://jezebel.com/thin-women-ive-got-your-back-could-you-get-mine-1173888442ref, a nonsensical over reach. The government is trying to instill in kids, the goals of eating healthily and exercising. This has nothing to do with being fat, and everything to do with developing healthy lives.

END OF LINE ;-) One tin soldier (talk) 20:35, 16 June 2014 (UTC)

I say go for it! ·FemiliskSJ 22:23, 16 June 2014 (UTC)
PS: Not that I won't edit it, but it's a place to start, as where we are now is poops. ·FemiliskSJ 22:24, 16 June 2014 (UTC)

[edit] Denialism

I think it could still fit into this category since the second part about being heavily overweight not being a problem is denialism to me. Any better suggestions? Zero (talk - contributions) 16:59, 18 June 2014 (UTC)

Here's the thing, and prove me wrong of course, but I see almost no real world people who are fat or who are fat activists actually denying that being overweight can be a health problem. but saying it *IS* a health problem, is itself denialism. more and more studies come out that talk about healthy fat people, and the effect of daily exercise (while being fat) on your health, etc. It is not universally true that being fat or obese is itself a health issue. It increases your RISKS, and that is the issue. Skiing increases a person's risk of tearing a knee, but many skiiers go their entire lives without problems. Being fat increases your chance of minor and major illness. but many fat people are fully healthy, and fat is not the only cause of not being healthy. (there are thin people with the same issues of Type 2 diabetes, heart problems, blocked artiers, bad posture and joint health, etc...) So it's not really denialism. it's more saying "let's look at what the science really says and word things clearly". One tin soldier (talk) 17:09, 18 June 2014 (UTC)
Exactly! ·FemiliskSJ 17:36, 18 June 2014 (UTC)
Furthermore, people who are overweight or obese are obstructed by medical professionals when they need to get treatment for their medical issues. Many people are told to just lose weight and that their problems are due to what's framed as a poor lifestyle choice-- when really they can have conditions that need treatment, fat-linked or not. Hundreds of woo and pseudo-medical products also use fat people as a pity idol, to give examples of people that are worse off than their customers, or promise weight loss (and social acceptance, beauty, positive body image) as a result of their nonsense. Fat people are thrown under the bus by exercise and diet ads with medical slants and used as "thinspiration" to not be like them, as if fat is the worst thing a person could be. Meanwhile, people who do wish to lose weight are bombarded with images that until they do, and until they make progress, they're worthless. So no, it's not denialism to be critical of people who claim being fat is always unhealthy. Even if someone is unhealthy and fat, this attitude obstructs them from getting effective treatment or even basic self-respect until they look thinner... even if their health problems don't go away post weight-loss.±Knightoftldrsig.pngKnightOfTL;DRgarrulous en guerre 17:46, 18 June 2014 (UTC)
Knight, you're missing Zero's point. He never implied that that was denialism. One Tin Soldier addressed the topic adequately above. Nullahnung (talk) 18:12, 18 June 2014 (UTC)
I know the above-mentioned obstruction exists and I know, too, that the physicians I work with see it as one of the more obvious things to discuss. That certainly reinforces the in-your-face feeling a patient might feel. I'm positive, too, that some docs say "We won't do anything 'til you lose weight" just like they might say similar things to smokers, regarding smoking. That's wrong, but I think the fact that there is something which meaningfully increases risk of bad health outcome makes it a health problem. It is a causal risk, but in a more complex system of causation (i.e. weight + other factors is causal, more so than weight alone). Weight loss advice should be one, just one, of the considered recommendations and all such advice should be delivered with dignity-for-all (cue sappy music). But, to me, saying weight is not a health problem sounds like denialism. It's one, just one, issue that may result in poor health. As for looking carefully at the science, yup, I agree completely.— Unsigned, by: MarmotHead / talk / contribs
And usually, being fat (overweight is a loaded term. who's definition of weight is 'the right weight' to be over) is indicative of other health issues which cannot easily be isolated from "being fat". Often fat persons do not (or at one time did not) eat well - so if they develop type 2 diabetes, is it cause they are fat, or cause of how they ate, or both? Often fat people do not exercise. So are the issues with their heart because they have excess weight, or because they don't get their heart up? The old studies said "being fat causes heart disease", but now more accurate tests are finding that lack of exercise and sleep play an even more important role. And, fat people often don't exercise of sleep. But it's impossible to say one caused the other. So when we start to pull away from the causality game, and talk risks, we get a more accurate picture of what is healthy. and it's not what BMI, or "overweight/underweight" charts tell you. It's far more complex than that.One tin soldier (talk) 18:33, 18 June 2014 (UTC)
I think we agree, except, perhaps, for labels. It's more complex, yup. As for BMI, it's an excellent research tool to describe populations, but completely inappropriate for clinical practice. It's just too damn easy to compute! MarmotHead (talk) 18:45, 18 June 2014 (UTC)
Indeed. From my experience in my adventures in weight loss (coming soon to a bookstore near you, but not really), many of the perils associated with being "fat" are not associated directly with body fat percentage, but rather come about from the fact that with the exception of a few disorders, the act of being fat often entails other unhealthy behaviours. I think it's unfortunate that it's often used as a catch-all to make doctors' lives easier, and it leads to serious misconceptions on how one can live a healthy lifestyle. Diet pills and starvation diets come about because people think losing weight at all cost is acceptable, while those who know the science behind it know that reaching some natural weight equilibrium should be a natural byproduct of maintaining a general healthy lifestyle. I had a friend who subjected herself to starvation diets, and it was absolutely heartbreaking when she did, as she was beautiful the way she was and was just proceeding to hurt herself with those diets. :( - Grant (talk) 19:03, 18 June 2014 (UTC)
My reasons for hating BMI is not that its used as a valuable (or not so) tool by trained medical professionals, but that the insurance industry has set it as a cut / dry case for "you will cost us money so you cost more". Oh, there's another reason to back off of teh "fat is unhealthy" as a rule. the insurance industry charges me nearly 300 bucks more than my husband for being fat. (you can't charge more for being a woman in Colorado, since long before obamacare's reforms). And every single test I've ever had for blood, heart, sugers, lipids, etc is in great shape, cause i do yoga each day, and eat quality things. yet I am fat, so I am charged more. a real discussion of and review of the relationship between fat (and other healthy / not healthy factors) and medical costs would be so helpful to people who are fat.One tin soldier (talk) 19:05, 18 June 2014 (UTC) (ec)
I hadn't even considered health insurance, coming from a country where such things are provided for free regardless of pre-existing conditions. I wasn't aware that insurance companies could discriminate on those grounds, and that seems kind of ridiculous. - Grant (talk) 19:08, 18 June 2014 (UTC)
A weight surcharge in this very state? Ugh! If it's based on BMI, that's even worse. As a tall person, BMI has me as obese since the formula adjusts to my height as a 2D person when I'm actually 3D (math babble relating to BMI denominator). Happily, my employer includes no such surcharge. I can see some logical reasons why there'd be a surcharge, but I do NOT like it. MarmotHead (talk) 19:15, 18 June 2014 (UTC)
Employer insurances almost never have costs related to pre-existing conditions, since they are group plans. where you see it is in self insurance. Smoking, age, sex (in many states, anyhow), prior conditions can all mean more cost. You have to be at the "right" BMI (not fat %, BMI) for 6 months or they will give you the higher rates. it's pathatic.One tin soldier (talk) 19:27, 18 June 2014 (UTC)

[edit] Page move from Fat activism to Fat acceptance movement

I'm much more familiar with the latter term myself but thought I'd ask for others opinions before moving. Obviously we could set up a redirect and such. Thoughts? --Drowninginlimbo (talk) 10:31, 25 June 2014 (UTC)

Please do. All the people over at Project SJ want this to happen. ·FemiliskSJ 10:53, 25 June 2014 (UTC)
I support this move, especially because the opening sentence also refers to "Fat Activism" as "Fat acceptance Movement" Can you say Gulag time? (talk) 10:55, 25 June 2014 (UTC)
I agree as well, fat acceptance is I think the proper terminology. ---Dgener8 (talk) 10:57, 25 June 2014 (UTC)
Yeah I saw the suggestion there and thought I should post something about it. I'll have a go at it now --Drowninginlimbo (talk) 11:23, 25 June 2014 (UTC)
Thanks! I'll tick off list! ·FemiliskSJ 11:25, 25 June 2014 (UTC)
It's okay, while you're here I'd like to say that you're doing good work with these articles. I'll try to contribute more substantially when I have more time for it --Drowninginlimbo (talk) 11:27, 25 June 2014 (UTC)
I am after all a gender scientist. ·FemiliskSJ 11:32, 25 June 2014 (UTC)

[edit] One piece of rejected edit

I added back a mere piece of a reverted edit: the fact-tag for the claim that overweight-plus-exercise can be just as healthy. I believe that claim is true, but it would be stronger if supported by a reference. MarmotHead (talk) 15:40, 7 August 2014 (UTC)

'Kay That's fine. I was being a a lazy jerk. Ikanreed (talk) 16:45, 7 August 2014 (UTC)
I was in the middle of being the same until the edit conflict thing (you were quicker on the draw) made me take a second look. MarmotHead (talk) 16:54, 7 August 2014 (UTC)

[edit] 2015 Clean Up

It is my goal for my first task on this wiki to clean up this article a bit. My first concern is that the "When body-positive turns negative" section has some entries I would argue are strawmen, or poorly sourced. For example, the claim that "Spreading medical myths, such as the long-debunked "95% of all diets fail" truism[17]" links to "Which comes from a poorly done study from the '50s" which is a New York Times article that quotes a psychiatrist (not exactly a subject matter expert) and declares one study from the '50s was bad. Linking to one newspaper article that claims something isn't true does not qualify as "long-debunked". Especially when there are a number of studies which support the assertion to be true: http://www.ncbi.nlm.nih.gov/pubmed/2663745?dopt=Abstract (97% failure rate), http://mann.bol.ucla.edu/files/Diets_don%27t_work.pdf (meta analysis of 31 studies on weight loss from dieting), and http://annals.org/article.aspx?articleID=735254&atab=7 (meta analysis of 46 studies) as a few examples.

Anyway, I plan to clean it up, but since this is my first time at this rodeo, I figured I would say something about my plan first, so everybody has a chance to chime in on the subject. Let me know if you have any feedback about this. Guardian (talk) 01:19, 21 February 2015 (UTC)

Hello, person that made most of those changes here. Well, admittedly, I was rushing through putting in sources as the previous edit had largely left the section blank and one-sided, so they may not be the best. Stuff happening IRL's been cramping my online time here, so I hadn't had a chance to clean it up myself.
Yyyyyyyeah, that line is actually one that I intended to remove/drastically change (but never got around to, on account of forgetting about it). The key point to it was that authors promoting fat acceptance generally dismiss dietary restriction as completely ineffective, usually with the line "95% of diets don't work", which is why I added the "(usu. followed with/implying "and thus you shouldn't try")". The main caveat to this is that nearly all such studies look at temporary diets/interventions, and studies following that are generally more poorly controlled the further out you get.
Several key behavior changes that occurred over the year of follow-up also distinguished maintainers from regainers. Not surprisingly, those who regained weight reported significant decreases in their physical activity, increases in their percentage of calories from fat, and decreases in their dietary restraint. Thus, a large part of weight regain may be attributable to an inability to maintain healthy eating and exercise behaviors over time. The findings also underscore the importance of maintaining behavior changes in the long-term maintenance of weight loss.
http://ajcn.nutrition.org/content/82/1/222S.long
In [2013] alone, 4 meta-analyses of diet comparison studies have been published, each summarizing 13 to 24 trials. The only consistent finding among the trials is that adherence—the degree to which participants continued in the program or met program goals for diet and physical activity—was most strongly associated with weight loss and improvement in disease-related outcomes.
—http://jama.jamanetwork.com/article.aspx?articleID=1730520
And as for the papers you posted:
  • http://www.ncbi.nlm.nih.gov/pubmed/2663745?dopt=Abstract - While the full paper is not available for public reading, an evidence review of the paper shows that the author expounds in the conclusion that the impetus for weight regain can still be overridden this way under the right circumstances, and longer-term obesity management or ongoing interventions may be needed.
  • http://mann.bol.ucla.edu/files/Diets_don%27t_work.pdf - A lot of studies, yes. But only 7 of which randomized controlled long-term studies. The author discusses the numerous methodological issues/follow-up issues/confounding factors of the other studies in the paper, including subject behavior after the study has ended. (Side note: this actually puzzled me. You say that a psychiatrist -- essentially an MD with a specialization in psychiatry -- is "not exactly a subject matter expert" on dieting and weight, but a psychologist -- no medical education needed -- is?)
  • http://annals.org/article.aspx?articleID=735254&atab=7 - It says right there in the limitations, "Studies were generally of moderate to poor methodological quality. They had high rates of missing data and failed to explain these losses. The meta-analytic techniques could not fully account for these limitations."
So, yes, most diets don't work, when "diet" constitutes a brief or temporary intervention. I can fully agree to removing that line as it is, but I'd like to replace it rather than just erase it. Noir LeSable (talk) 05:17, 10 March 2015 (UTC)
Sorry I wandered off for a bit as well. I am going to try to respond to a couple of your specific points, but in general I think a discussion of the goal of this page is the best course. If we can establish an agreement in purpose, we will much better be able to discuss details of specific items, yes?
Just to not get too muddled, I will start with my responses, and then talk about the big picture.
So in reference to the two quotes talking about subjects failure to adhere to protocol being a potential cause for failure to maintain results. It seems to me that you are presenting that as a counter-argument to the claim that diets in general fail, but those quotes are essentially offering one potential reason why they do fail. If the argument being vetted is "dieting for weight loss doesn't result in long term weight loss to any statistical significance in a population" then saying "well it is because people aren't sticking with the diet" rather reinforces the point that the diets do in fact fail, it doesn't counter it.
As to the psychiatry/psychology question. I don't know your familiarity with how medical training works in the US, but my wife is an MD/MPH so I have a fairly close up view on the process. I would say that it is not at all accurate to say that psychiatrists just are normal doctors with a specialization. All doctors get basic science and anatomy education in their 1st and 2nd years of medical school, and an exposure to all the various forms of medicine in their 3rd and 4th year to enable them to choose a direction. They don't actually practice medicine and learn how to be doctors until they are in residency. The 1st year of residency (the internship) is roughly the same for all doctors with the exception of about 25% of their time being devoted to their specialty while the remainder is indeed learning a general understanding of medicine. However, after that first year doctors of psychiatry get basically no further training that isn't directly related to their specialty. So it is not accurate to suggest that they are subject matter experts in general medicine or the treatment of non-psychiatric illness (such as maintenance of weight and general health, diabetes care, or the like). In this particular case, my argument was that the doctor being a psychiatrist suggests that his claim that the origin of "95% of diets fail" is one specific study from the '50s says more about his lack of familiarity with the full body of work on the subject then anything else. So basically, a New York Times health writer asking some random doctor to validate a claim outside his field doesn't seem to me to be a strong basis for that claim. While on the other hand, a group of psychologists are not being asked their expert opinions, they are performing original research doing a meta-analysis. So in their case, their knowledge of the medicine involved (and their lack of medical training) is not really important, only their skills at research and statistics are important. So I say in the case of that study, critique of the methodology is important, but the authors training isn't if they are doing their math correctly.
I am not sure I need to offer counter arguments to your responses to the other studies I linked, as at the end you agree with the point I was trying to back up with them: "most diets don't work". Honestly, I think the broader argument that diets don't work to achieve their goal long term is that you can't find any studies showing that they do. People will obviously debate how much effort is required in searching for such evidence before we can say "it doesn't exist"; but in my case, my wife's MPH thesis was on the causes and treatment of obesity in a primary care setting, and we spent nine months trying to find that evidence without turning up anything. So unless the citation is "I looked for evidence and couldn't find any." I am not sure how we go about proving it outside of the sorts of studies I linked.
Really the strongest argument I can offer for proof that diets don't work long term at a population level is that the US effort to "fight obesity" over the past 70 years has been a resounding failure, and calorie restriction of every sort has been the primary method used that whole time, to little effect. I think that is a strong argument, but it makes for a lousy citation.
With that behind me, I want to discuss the goal here.
It seems to me that the purpose of this page should be to present what the FA movement is and what its arguments are. Those arguments should be vetted for rationality and rigor. The first part of that is that we need to present their arguments not only accurate to what the movement actually argues, but that we must use the strongest forms of those arguments we can find. Otherwise, we run the risk of setting up strawmen. It is possible to find blog posts that advocate for FA in completely absurd and unrealistic terms that misunderstand the laws of physics, and perhaps it is worthwhile to include a section talking about how some adherents are full of failure. But I don't think it is fair to frame the entire movement "turning negative" with what seems like a lot of links to people poorly presenting the issue.
What I want to do is try to greatly expand the top half of the article to more thoroughly and comprehensively present the positions of the FA movement, and include the critiques of those positions along with them as they come up. Currently, we have the heading that describes a single facet of the movement (Rejection of idealized body types) which then attempts to cover the entire movement in one fell swoop. This is then followed by a longer section attacking the movement then is even spent explaining it. I just don't feel like we are currently giving it a very fair shake at all.
My concern is, if I just launch into a full fledged rewrite of the entire article the conversation will quickly devolve into an argument about the merits of the movement itself, rather than a discussion of how to best present the actual aims and evidence the movement has. So before I make all that effort, I want those of us who are inclined to make that decision to get through it here first. We need a common vision of what the page is attempting to do, so we can then work on executing that.
Thoughts? Guardian (talk) 17:43, 6 April 2015 (UTC)
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