Shriver writes that her older brother is "a sadly good test case for the claim that one can be 'healthy at every size.'" He weighs 330 pounds, and suffers from compressed vertebrae, diabetes, emphysema, and heart problems. Shriver says he received serious injuries that left him unable to exercise, but that "he also eats too much." And while she has "buckets of sympathy for the obese" and "respect [...] for their feelings, for their humanity," she also writes,

I won't simply accept that my brother is fat. And his only chance at a future is to refuse to accept himself that his weight gain is irrevocable. [...] My brother is only 55, and without drastic intervention – gastric bypass surgery or a sudden resolve on his part that I fear is unlikely – I doubt he'll see 60. My brother is eating himself to death. I love him dearly, and I can't support any political movement that would have him believe he can be "healthy at any size."

Shriver's piece is heart-wrenching to read in light of its coda — her brother died of cardiac arrest soon after it was written. Even without this information, Shriver's concern for her brother's well-being is palpable — she's not that family member who says "I'm just worried about your health," but really wants you to fit into a size 4 dress. Not all fat people are healthy, and it's possible that losing weight would have improved Shriver's brother's life.

But. Health At Every Size did not kill him. First of all, fat acceptance doesn't mean believing every fat person is in perfect health — fat people with cancer obviously still have cancer, no matter how you feel about their weight. Being fat does seem to raise the risk of some health conditions — but so does being thin. Ultimately, the message of Health At Every Size isn't that fat people suffer no health problems, it's that the way to combat health problems (usually) isn't major weight loss — because most of the time it doesn't work. Would weight-loss surgery have extended Shriver's brother's life? Maybe, but the surgery carries risks too. And whether or not he might have benefited from some sort of drastic intervention, the message of Health at Every Size isn't that he was healthy, or that he should have simply ignored his diabetes or heart issues. In fact, it's possible to believe in fat acceptance and have weight-loss surgery. What's not possible: that a movement that teaches that you can be healthy and fat made a man unhealthy.

The trailer for Fat Girls Float, currently seeking funding on Kickstarter, is a good place to get the truth about fat acceptance. (Thanks to the tipster who sent it in this morning.) The film, by self-described "300lb. filmmaker" Kira Nerusskaya (pictured) lets "fat women from four countries (England, France, Russia, and the United States) tell their tales of sorrow and success, wow and woe; discussing size discrimination, political activism (fat and size acceptance), and social networking communities." Interviewees include Velvet D'Amour, who points out that fat characters in Disney films are always evil, and asks, "when is fat Cinderella?" But the real show-stealer of the trailer is a woman named Colleen (pictured above), who says,

If anyone thinks that they are so important and so special that I will give them the power to change my life, to change my attitude, my smile, my frown, if you think you are going to have any effect on that whatsoever, you're mistaken. You have no power. You have no power over me.

Shriver's essay is more moving and personal than the mainstream media's typical anti-fat screeds, but at bottom, its message is an old one — that if we don't keep harping on the idea that fat itself is unhealthy, fat people are going to keep dying. Unfortunately, this is true. Fat people are going to keep dying no matter what we say to them. So are thin people. Everyone dies. While Shriver's brother's death is tragic, stigma definitely wouldn't have saved him. When Shriver calls HAES a "political movement that would have him believe he can be 'healthy at any size,'" she misses the point — nobody could truthfully call her brother healthy when he wasn't. All HAES and fat acceptance aim to do is to decouple health from fat discrimination, and to help fat people protect the self-respect that society tries to take away. Shriver says she has "buckets of sympathy for the obese," but Colleen doesn't need her sympathy. She's secure enough in herself that stigma can no longer hurt her — and she is the real face of fat acceptance, not some notional fatty feeding a sick man lies.

Lionel Shriver: My Brother Is Eating Himself To Death [Guardian]
Get In The Pool! With Fat Girls Float [Kickstarter]

The semi-reasonable controversy that attends any fat-specific gathering or event — nightclubs, yoga classes, pool parties, reality dating shows — is not even mentioned in the article, but I'll recap it here anyway. "But why should fat people be segregated?" it goes. "Isn't the point to be more inclusive, not to shove some people off to the side?" It's a well-meaning argument, but I'll tell you what, I rarely hear actual fat people making it. Because we know that while there may not be "No fatties" signs on many doors, there are velvet ropes and bouncers. And yoga instructors who have no clue how fat bodies work, and assholes who will sneer and snicker at the lardass who dares to wear spandex to the gym or a bathing suit to the pool (as if we don't even know how gross that is!), and Bachelors who would laugh the cutest, sweetest chubster right out of the mansion on the first round. And even though there are absolutely fantastic, size-friendly clubs and studios and gyms and pools and probably even reality show contestants all over this great nation, if they don't explicitly advertise themselves as such, fat people can only find them by trial and error. And by "error," I mean "public humiliation."

So hell yes, I would rather go to Club Bounce than someplace where the bouncer may or may not even let my fat, thirtysomething ass in the door, the bartenders may or may not acknowledge my existence, and the other patrons may or may not give me dirty looks or fail to stifle their laughter. (And all of this goes double for a lot of people fatter than me.) Full inclusion at establishments for "normal" people is certainly the long-term goal, but in the meantime, if somebody rolls out the fatty welcome mat, you can bet I'll be happy to spend my money there, just to remove the stress of not knowing if I'll be treated like a real human being.

But like I said, that's not even the controversy mentioned in the article. Instead, it's the same old argument used against making fashionable plus size clothing available, or increasing the visibility of fat people on TV, or granting us health coverage at all, let alone without penalties, or saying out loud that it is possible to find love while fat: But if we give them nice things, they won't have any motivation to lose weight! "The very nature of such venues," says the Associated Press, "has led some to question whether they are encouraging people to remain fat in a society where, according to the Centers for Disease Control and Prevention, one-third of adults are already obese."

As in all of those other cases, the argument is fundamentally a load of bigoted horseshit. But in this case, it's also patently absurd. If we want to solve the obesity crisis, we can't let fat people dance! Why, that's a form of exercise, and if we want fat people to be healthier, we can't have them...

Wait, what? How does this make even the tiniest shred of sense? Answer: It doesn't, unless you believe that allowing fat people to get within a country mile of anything that smacks of self-esteem, happiness, or enjoying their bodies as they are is "encouraging obesity." Which, of course, is exactly what a lot of people do think, as demonstrated by all of the above arguments. If we just stopped letting fat people wear clothes and go to the doctor when they're sick and, you know, ever leave the house, they'd all either die or get thin! Obesity crisis solved!

So, naturally, a writer who thought that was a line of reasoning logical enough to acknowledge in the first place concludes that the good thing about clubs like Bounce is that they might motivate people to lose weight! "Although obesity remains a serious problem, with links to diabetes, heart disease and other health issues, says sociologist Karen Sternheimer, creating a place where people can feel good about themselves can build self-esteem, which in turn can prompt people to do something about their weight." Or, you know, it can prompt them to pursue health and happiness and love and the full human being treatment just as they are, instead of fighting a losing battle with their bodies (plug plug), but Sternheimer doesn't seem to care so much about that. Nevertheless, I agree with her on one point: "Anything that helps people feel better about themselves, there's something positive to that."

Nightclubs For The Plus-Size Start to Take Shape [Fox News]

Related: Living Large [Salon]
Fear Of Fat [Bitch]
Heavy Infant In Grand Junction Denied Health Insurance [Denver Post]
The Museum Of Fat Love [MoFL]

Tara Parker-Pope's recent post about it at the NYT's Well blog inspired me to catch up. From a Professional Unapologetic Fatass (hereafter, PUF) perspective, the post struck me in much the same way the first two episodes of the show did: Close, but not quite. (More on that in a moment.) My first impression was: Much better than a weight-loss competition or Fat Chicks Crying, but still a bit too stereotypey for my tastes.

If you're not familiar with the show's premise, it's this: A vapid aspiring model, Deb, dies and is returned to earth in the size-16 body of a brainy, workaholic lawyer, Jane. New Jane has Deb's memories — which include the calorie counts of everything, like the half-grapefruit and Splenda she used to eat for breakfast — combined with Old Jane's intelligence and legal expertise. (Yeah, don't ask; if that's too great a challenge to your willing suspension of disbelief, this isn't your show.)

The odd marriage of a chronic dieter's memories and an apparently resigned, if not unapologetic, fat girl's brain and body, says Parker-Pope, "raises an obvious question: Given Deb's success at maintaining a model-like figure, why doesn't she just put her new body on a diet and lose the weight?" Well, that's one of the first things she tries, as it turns out. But "she discovers that Jane's body craves chocolate and Cheez Whiz. When she is inside Jane's body, Deb says: 'I don't like celery. I like sandwiches.'"

Parker-Pope seems to uncritically accept that answer, which was the one thing I didn't like about the show when I first watched it. This idea that the desire to suck EZ Cheez straight from the can is somehow embedded in Jane's body, regardless of whose brain is doing the driving, only reinforces the stereotype that fat people are uncontrollably drawn to junk food. (See also: Jane/Deb losing the ability to concentrate while in the presence of doughnuts. Seriously.) If they'd played it just as Deb suddenly feeling like she had an excuse to eat, and bingeing to make up for years of calorie restriction, I might have been on board. But no, at the end of the day, Deb likes celery (and grapefruit and Splenda even in mojitos), and Jane likes sandwiches (and doughnuts and fried calamari and EZ Cheez). And I mean, that's fine — I also like many of those things, and I'm sure a lot of fat people do like all of them. But so do a lot of thin people.

I realize you can't have a fish-out-of-water comedy without extremes, but when you're explicitly claiming a fat power message — and the folks behind DDD are — implying that the only reason New Jane can't lose weight is because Old Jane's zombie fat cells demand junk food kinda misses the mark. Well, actually, that's not the only reason. We're similarly meant to believe that Jane — that's her (Brooke Elliot) in the photo up there — is so out of shape she cannot complete a single squat, much less the hours of exercise Deb would like to put her through. Again, it's fine to have a fat character who's so overworked she can't find time for the gym, just like a whole bunch of real people of all sizes, but seriously? An able-bodied, 30ish woman who's just barely over the plus-size line* can't do one effin' squat? Especially when she's played by Brooke Elliott, who's sung and danced on Broadway? I call bullshit. More specifically, I call lazy stereotype.

Or rather, I called lazy stereotype, before I caught up on more recent episodes. In episode 7, I was stunned to see a much better explanation for why Jane's body remains fat. The legal case of the week revolves around a 500-calorie-a-day commercial diet program that may have caused heart problems in a young girl who used it. And the twist (spoiler alert) is, after New Jane takes the case, we learn that Old Jane not only tried the same product but at one point endorsed it. Obviously, this throws a wrench in the case, and it prompts New Jane to visit her old doctor, where she learns more about her dieting history.

Check that shit out! In a two-minute clip, we learn:

• Old Jane was, in fact, a veteran dieter — like many, if not most, fat chicks — not merely a sedentary spray-cheese devotee who was somehow immune to cultural pressure to lose weight.
• When trying to lose weight, Old Jane would quickly plateau and then gain it back because, according to her Fairy Goddoctor (so named because damn, this is not the average fat person's doctor visit, even though it ought to be), her body just wouldn't let her keep starving. Quoth the Fairy Goddoctor: "It has nothing to do with willpower." (!!!!!!)
• Old Jane wanted gastric by-pass surgery, but Fairy Goddoctor "wouldn't even give [her] a brochure." Christ, I wish this doctor were real.
• Fairy Goddoctor believes that realistically, dieting "success" will almost always be short-lived.
• Jane's blood pressure is "a little high" because she's anxious, not because she's fat.

I can safely say I have never seen anything even a little bit like that on TV in my life. And speaking as a PUF, I have a whole new love for this show because of it. (So much so that I'll even forgive them for the bit where she lies to the doc about going to the gym. Reinforcing stereotypes of fat people as both sedentary and medically non-compliant? Yes. Fairly realistic and delivered rather adorably by Elliott? Also yes.)

Other recent episodes mostly bore out my new love for DDD, though I still have a fundamental problem with it, which is an unfortunate side effect of the premise: To wit, we are not seeing the experiences of a professional, competent, cute-as-a-bug's-ear fat woman, but the experiences of a thin woman suddenly forced to give thought one to what it's like to be fat. And that means, for instance, that we get an entire episode built around New Jane's shock and outrage upon learning that a Rodeo Drive boutique doesn't carry dresses in her size — and gasp! the salespeople are rude to fatties — which leads to an ill-advised (and realistically ill-fated) discrimination lawsuit against the company.

The lack of fashionable plus-size options — and respect for the market — is real and shitty, but an actual fat woman would A) not be all gollygeewhiz surprised by this and B) likely have bigger and better fish to fry where discrimination suits are concerned. So, although it's realistic that Deb would be both learning this for the first time and dumb enough to believe there's a lawsuit in it, the fact that she's doing it in Jane's body subtly reinforces one of my least favorite Hollywood stereotypes: The fat girl who doesn't know she's fat. The fat girl who doesn't realize she's not a 24-year-old model, and thus humiliates herself by acting entitled to all the rights and privileges pertaining to conventional attractiveness. That's a really common trope, among the rare instances when you see a fat girl on TV at all — she has no idea that other people are offended by her appearance, that the captain of the football team doesn't really want to take her to prom, that people think she eats too much, that she can't wear straight sizes, that any effort she puts into looking pretty will read as a big joke on her. It's usually based, as far as I can tell, on the assumption that fat people are ignorant not only of nutrition and exercise recommendations, but how they're perceived in society — 'cause if they knew how much people hate them, they would have lost weight already, amirite?

Here, obviously, it's based on the conceit that this particular fat girl is also a 24-year-old model. But I just don't think we've come far enough from that other version of The Fat Girl Who Doesn't Know It for the underlying premise here — as DDD creator Josh Berman told Parker-Pope, "I always liked the idea of a woman who doesn't feel on the inside like she looks on the outside" — to be 100% empowering. It leads, just a bit too often, to New Jane looking like a buffoon in all-too-familiar ways. (And that's without getting into the fact that looking like Brooke Elliott on the outside is hardly the raw deal it's made out to be.)

More disturbingly, it raises another question that should be obvious: What happened to Old Jane, anyway? And the answer is: She's dead. Literally. She died so that Deb could live. We're meant to believe Old Jane was self-loathing and lonely, so being body-snatched by someone more sexually confident is trading up, but unfortunately, that means this isn't the story of a fat woman learning to love herself as-is, but a fat woman fucking dying so a thin woman can learn a valuable lesson. I don't think I'll ever completely get past that.

But I can get past it enough to enjoy Drop Dead Diva for what it is — a fairly typical Lady Network show with a lot of atypical, unprecedented, truly body-positive twists. It's not 100% PUF-approved, but holy crap, it's a better portrayal of a fat woman than damn near anything I've seen since Roseanne, so I would really like to see this show do well. Since they already seem to have cut down on the binge-eating gags in recent episodes (THANK YOU), and they can only do so much about the premise, all I can really ask for is a little more sensitivity to the pitfalls of having Deb learn shit in Jane's body that should be obvious to any thinking person, fat or thin. Oh, and more Fred. For the love of all that's holy, do not take Fred away from us again.

*Before somebody argues that point, the line I'm referring to is 14/16W, where most plus lines begin. And as anyone who's ever had the misfortune of falling between them can tell you, there's actually quite a gulf between a "straight" 14 or 16 and a 14 or 16W.

In TV Series, Some Reality On Weight [NYT]

A new report from the Institute of Medicine does just that, calling on local governments to make it easier for their citizens to exercise and access fresh food (yay!) in hopes that it will prevent kids from getting fat (oh, did you have to?).

I can't say it any better than I already said it in response to a similar story out of Europe last year:

Free fruits and veggies for everyone! Local, organic produce for all my friends! While you're at it, bring back gym class and train future phys ed instructors to focus on encouraging the joy of movement instead of forcing everyone to move their bodies in exactly the same way, regardless of any pain (physical and/or emotional) it causes! Subsidize exercise facilities until they're affordable for everyone! Create more bike paths! Clean up local bodies of water so everyone can swim for free! Build cities on the scale of human bodies instead of cars, and keep the streets safe enough for everyone to walk around! Ban high fructose corn syrup! Keep fast food and soda and junk food corporations out of the schools! Raise the minimum wage and shorten working hours so people have more time to cook and be active! KNOCK YOURSELVES RIGHT THE FUCK OUT creating an environment that makes it easier for everyone to eat a variety of fresh foods and get plenty of exercise!

But don't tell me that's going to make everyone thin - and really, really don't tell me that making people thinner should be the main point of such a plan. It fucking infuriates me that with all of the many, many excellent reasons to do all the things I've just suggested, the only potential outcome that can muster the political will to enact any of it is weight loss. Fuck having a cleaner, safer, more fun environment that might lend itself to people generally feeling more energetic and vibrant (which might also lead to more productivity, for all the hardcore capitalists out there) - unless we can get rid of the fatties, it's wasted money.

And even if you're not as fat-friendly as I am, there's still the fact that these programs don't really make much of a difference in childhood obesity. As it turns out, losing weight and preventing weight gain are a lot more complicated than, as AP writer Lauran Neergaard infuriatingly puts it, "being more active and eating more fruits and vegetables instead of fatty fast food and treats." (Neergaard also trots out the "doctors worry that we're raising generations who no longer may outlive their parents" canard, despite U.S. life expectancy currently being at an all-time high.) The Shape Up Somerville program, a three-year intervention that took place in the Boston suburb between 2002 and 2005, is held up as a successful model of community fat-fighting. It's true that Shape Up Somerville did some awesome things for the community — it improved the quality of school food, creatively introduced joyful movement into classrooms, and made it easier and safer for kids to walk to school — but the evidence that it made a dent in childhood obesity is less than compelling:

On average, SUS reduced approximately one pound of weight gain over eight months for an eight-year-old child. This may seem small for an individual, but on a population level this reduction in weight gain, observed through a decrease in BMI z-score, would translate into large numbers of children moving out of the overweight category.

Note that that's one pound of projected weight gain, based on a guess about who was at risk for gaining how much weight. And remember that children grow in fits and starts, sometimes going from chubby to lanky in a very short period of time. And then ask yourself why a bunch of kids not gaining one pound could "translate into large numbers of children moving out of the overweight category." If you said "arbitrary fucking BMI cut-offs," you win a Lady's Brunch Burger! Meanwhile, the Shape Up Somerville program also did its best to shame and terrify children and their parents regarding things food and fat, even more than the rest of the world already did. All to prevent an average of one pound of hypothetical weight gain.

I know a lot of researchers believe that Health at Every Size, or health for its own damned sake, is too hard a sell; most people aren't nearly as interested in being healthier as they are in being thinner. But the reality is, eating a bit less and moving a bit more do not make fat people permanently thin, or prevent kids with fat genes from fulfilling their chubby little destinies. They can, however, make people feel a lot better, and reduce the incidence of "obesity-related" illnesses. Initiatives that make cities more pedestrian- and bike-friendly, gym class more fun, and school lunch less nauseating have a gazillion merits that have nothing to do with preventing weight gain — yet they'll be considered failures if they don't. I just don't even know what to say about the fact that making people's lives better is not a good enough reason to spend tax dollars on such improvements, but ridding the world of fat children is.

Report: Tips on creating fat-fighting communities [AP]
On Problems to Be Solved [Shapely Prose]
Shape Up Somerville [Friedman School of Nutrition Science Policy]
Health at Every Size [Linda Bacon]

Writer Mandy Katz's analysis of the zeitgeist is a little silly (is the show More to Love really an example of Fat Acceptance? Is Oprah, with her public confessions of "embarrassment" about her weight, really a paragon of Health At Every Size?), but the basic message of her article is worth repeating. "A loose alliance of therapists, scientists and others," she writes, believe,

that all people, "even" fat people, can eat whatever they want and, in the process, improve their physical and mental health and stabilize their weight. The aim is to behave as if you have reached your "goal weight" and to act on ambitions postponed while trying to become thin, everything from buying new clothes to changing careers. Regular exercise should be for fun, not for slimming.

It's not a new concept, as Katz acknowledges, but it's still a controversial one. Katz quotes Walter Willett, chair of the nutrition department at the Harvard School of Public Health, who says,

Virtually everyone who is overweight would be better off at a lower weight. There's been this misconception, fostered by the weight-is-beautiful groups, that weight doesn't matter. But the data are clear.

Leaving aside his dismissive tone, Willett doesn't mention how "everyone who is overweight" is supposed to get to "a lower weight" and stay there, probably because there's no reliable answer. Given the fact that trying to change your weight often leads to yo-yo dieting (Kathryn Griffith, interviewed in the article, has been through Weight Watchers 27 times), it's no wonder a variety of people have decided to just eat what they want already — that is, to choose "intuitive eating." A companion article, also by Katz, defines intuitive eating thus:

Intuitive eating involves returning to basic drives, dispensing with the notion of "good" or "bad" foods and rules about when to eat. Absent a fear of deprivation, the philosophy holds, one's hunger and taste cues - rather than cognitive rules - provide the most trustworthy guide toward balanced, healthy eating.

Some claim (this is Corinna Tomrley's critique of Susie Orbach) that this kind of eating will make you thin. But Kate Harding of Shapely Prose tells Katz that when she quit dieting,

I thought, ‘O.K., maybe I could be a size 10, and it won't be so bad.' As it turned out, I ended up as roughly an 18, which was exactly where I started.

Really quitting dieting may mean not just letting that Weight Watchers subscription lapse, but also giving up thinness as a goal. It's still incredibly difficult, because people like Willett (and every women's magazine ever) continue to insist that it must be everyone's goal. But psychologist and eating disorder specialist Deb Burgard says, "the pursuit of thinness as a dream is a place holder. It gets in the way of asking, ‘What is it I am dreaming of?' "

This may be true not just for individual dieters, but for our diet-obsessed society in general. Also in the Times, Roger Cohen writes about the recent study that shows that calorie-restricted monkeys live longer. The child of a primate expert, he examines a now-famous photo of two monkeys, Owen and Canto — and thinks Owen, the well-fed one, is probably happier. He writes,

It's the difference between the guy who got the marbleized rib-eye and the guy who got the oh-so-lean filet. Or between the guy who got a Château Grand Pontet St. Emilion with his brie and the guy who got water. As Edgar notes in King Lear, "Ripeness is all." You don't get to ripeness by eating apple peel for breakfast.

"When life extension supplants life quality as a goal," he continues, "you get the desolation of Canto the monkey." Long life and even health have become goals in themselves, and we seemed forgotten that a long healthy life is for something — enjoyment. When we take health, longevity, or thinness for that matter, as ends rather than means, we get our priorities screwed up. We think it's acceptable to tell people to starve themselves so that they can fit Willett's definition of what's healthy — or Vogue's definition of what's attractive. We'd be better off remembering that health is about being able to do things with your life — including eat — and that thinness is about, well what is in thinness about exactly? If you look at a women's magazine, it's about health, yes, but also attractiveness, happiness, and personal empowerment — all of which can be achieved at any size.

Tossing Out The Diet And Embracing The Fat [NYT]
To Eat Well, Be Instinctive [NYT]
The Meaning Of Life [NYT]

Bacon's research has shown that the "Health at Every Size" approach is more effective than weight loss as an ultimate goal. She ran a trial where half the women were in a HAES group and the other half were in a traditional, weight-loss focused dieting group. While the HAES group did not lose weight, the Times notes, "their healthier behavior led to lower blood-pressure and cholesterol levels, which stayed low even two years later. In the weight-loss group, more than 40 percent dropped out before the six-month low-calorie diet ended, and at the two-year follow-up, the average dieter had regained all her lost weight, and the only measurement that dropped was one for self-esteem."

Low self-esteem can be a big problem for obese women who are attempting the HAES approach, as a new study presented at the Obesity Society's annual meeting shows, many very overweight women avoid exercise because they feel self-conscious about working out.

Another weight-oriented study, this one involving tweens, shows that heavy girls aged 9-13 who read a book with an overweight heroine lost more weight than girls who read a book without weight themes. Time reports that the girls who read Lake Rescue, a novel "whose protagonist is an overweight preteen who struggles with low self-esteem, feelings of isolation and teasing because of her size," lost .71 from their BMI, while those who read the non-weight oriented Charlotte in Paris lost only .33 from their BMI. The heroine of Lake Rescue ends up learning to make healthy food choices and embrace physical exercise.

Even though these girls lost weight, it seems that presenting them with a heroine who is ridiculed because of her size is not an ideal way to get them to eat healthily. Like 12-year-old girls don't have enough shit to deal with; maybe they should be getting Linda Bacon's book instead.

Losing The Weight Stigma [NY Times]
Obese Women Face Many Exercise Barriers [UPI]
Can Reading Help Kids Lose Weight? [Time]
Health at Every Size [Amazon]