Monday, 5 December 2016

Dieters Gain More Weight in Pregnancy


Care providers often push "obese" women to lose weight before pregnancy in hopes that weight loss will reduce complications and make for a healthier pregnancy.

However, one consequence they often fail to consider is that the woman who loses weight before pregnancy often gains excessively during pregnancy.

This is logical; the body thinks it is starving already; once pregnant it feels it has to get even more efficient in order to sustain the mother and provide enough energy for the baby to grow. Thus, the body holds on even more to every calorie it does get and the woman experiences a higher weight gain during pregnancy, even though she may be eating perfectly reasonably.

Here is a brand-new study showing that women who practice "dietary restraint" (dieting, weight cycling, restrained eating) before pregnancy tend to gain more weight in pregnancy. The study noted:
Multivariable analysis revealed that restrained eating, weight cycling and dieting were associated with higher absolute weight gain, whilst weight cycling only was associated with excessive weight gain.
This is not the first study to find a higher gain in women who diet before pregnancy. Another study in 2008 had similar findings. It noted:
Restrained eating behaviors were associated with weight gains above the Institute of Medicine's recommendations for normal, overweight, and obese women.
And another study from 2013 showed that low-income women who experienced food insecurity and have a history of dieting may be particularly at risk for high gain during pregnancy.

Yet most caregivers continue to recommend weight loss before pregnancy to high-BMI women, and many researchers call quite aggressively for it. They do not seem to realize that the trade-off for significant weight loss before pregnancy may well be a high weight gain during pregnancy.

This is especially troublesome considering the intense pressure some care providers place on obese women to restrict their weight gain to almost nothing during pregnancy. It's like they are setting up women of size to fail from the get-go.

A better approach is to encourage women of all sizes to practice Health At Every Size®, which means to place the emphasis on eating well and getting regular exercise without emphasizing weight loss or the scale. 

There's nothing wrong with encouraging healthy habits before pregnancy, and this can be an important part of pre-conception care ─ but the emphasis on weight loss before pregnancy at all costs may be counter-productive.


References

Appetite. 2016 Dec 1;107:501-510. doi: 10.1016/j.appet.2016.08.103. Epub 2016 Aug 19. Effects of dietary restraint and weight gain attitudes on gestational weight gain. Heery E, Wall PG, Kelleher CC, McAuliffe FM. PMID: 27545671
The aim of this study was to examine the impact of dietary restraint and attitudes to weight gain on gestational weight gain. This is a prospective cohort study of 799 women recruited at their first antenatal care visit. They provided information on pre-pregnancy dietary restraint behaviours (weight cycling, dieting and restrained eating) and attitudes to weight gain during pregnancy at a mean of 15 weeks' gestation. We examined the relationship of these variables with absolute gestational weight gain and both insufficient and excessive gestational weight gain, as defined by the Institute of Medicine recommendations. Multivariable analysis revealed that restrained eating, weight cycling and dieting were associated with higher absolute weight gain, whilst weight cycling only was associated with excessive weight gain. There was no evidence that the relationships between the dietary restraint measures and the weight gain outcomes were mediated by pregnancy-associated change in food intake. Increased concern about weight gain during pregnancy was independently associated with higher absolute weight gain and excessive weight gain. These relationships were attenuated following adjustments for pregnancy-associated change in food intake. These findings suggest that in early pregnancy, both a history of fluctuations in body weight and worry about gestational weight gain, are indicators of high pregnancy weight gain. Concern about weight gain during pregnancy seems to partly arise from an awareness of increased food intake since becoming pregnant. Prenatal dietary counselling should include consideration of past dieting practices and attitudes to pregnancy weight gain.
J Am Diet Assoc. 2008 Oct;108(10):1646-53. doi: 10.1016/j.jada.2008.07.016. Dietary restraint and gestational weight gain. Mumford SL, Siega-Riz AM, Herring A, Evenson KR. PMID: 18926129
OBJECTIVE: To determine whether a history of preconceptional dieting and restrained eating was related to higher weight gains in pregnancy. DESIGN: Dieting practices were assessed among a prospective cohort of pregnant women using the Revised Restraint Scale. Women were classified on three separate subscales as restrained eaters, dieters, and weight cyclers. SUBJECTS: Participants included 1,223 women in the Pregnancy, Infection, and Nutrition Study. MAIN OUTCOME MEASURES: Total gestational weight gain and adequacy of weight gain (ratio of observed/expected weight gain based on Institute of Medicine recommendations). STATISTICAL ANALYSES PERFORMED: Multiple linear regression was used to model the two weight-gain outcomes, while controlling for potential confounders including physical activity and weight-gain attitudes. RESULTS: There was a positive association between each subscale and total weight gain, as well as adequacy of weight gain. Women classified as cyclers gained an average of 2 kg more than noncyclers and showed higher observed/expected ratios by 0.2 units. Among restrained eaters and dieters, there was a differential effect by body mass index. With the exception of underweight women, all other weight status women with a history of dieting or restrained eating gained more weight during pregnancy and had higher adequacy of weight gain ratios. In contrast, underweight women with a history of restrained eating behaviors gained less weight compared to underweight women without those behaviors. CONCLUSIONS: Restrained eating behaviors were associated with weight gains above the Institute of Medicine's recommendations for normal, overweight, and obese women, and weight gains below the recommendations for underweight women. Excessive gestational weight gain is of concern because of its association with postpartum weight retention. The dietary restraint tool is useful for identifying women who would benefit from nutritional counseling prior to or during pregnancy with regard to achieving targeted weight-gain recommendations.
Appetite. 2013 Jun;65:178-84. doi: 10.1016/j.appet.2013.01.018. Epub 2013 Feb 10. Food insecurity with past experience of restrained eating is a recipe for increased gestational weight gain. Laraia B, Epel E, Siega-Riz AM. PMID: 23402720
Food insecurity is linked to higher weight gain in pregnancy, as is dietary restraint. We hypothesized that pregnant women exposed to marginal food insecurity, and who reported dietary restraint before pregnancy, will paradoxically show the greatest weight gain. Weight outcomes were defined as total kilograms, observed-to-recommended weight gain ratio, and categorized as adequate, inadequate or excessive weight gain based on 2009 Institute of Medicine guidelines. A likelihood ratio test assessed the interaction between marginal food insecurity and dietary restraint and found significant. Adjusted multivariate regression and multinomial logistic models were used to estimate weight gain outcomes. In adjusted models stratified by dietary restraint, marginal insecurity and low restraint was significantly associated with lower weight gain and weight gain ratio compared to food secure and low restraint. Conversely, marginal insecurity and high restraint was significantly associated with higher weight gain and weight gain ratio compared to food secure and high restraint. Marginal insecurity with high restraint was significantly associated with excessive weight gain. Models were consistent when restricted to low-income women and full-term deliveries. In the presence of marginal food insecurity, women who struggle with weight and dieting issues may be at risk for excessive weight gain.


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We’re Fat People, Not Metaphors

Actual SizeOne of the ways that weight-based bigotry is perpetuated is the use of fat people and being fat as metaphor.  Recently reader Jen commented about a situation where this was happening to her and gave me permission to blog about it.

I am the only fat person, in a group of 14 people, for whom issues like alcoholism, drug abuse and domestic partner violence seem to play third chair to the issue of: “at least I don’t look like her.” And no, I can’t prove this, but when half of the examples from the books that the groups’ facilitators use have to be examples of how “not to eat too much”, “because that is a short time reward vs a long time goal” (ie a cookie vs weight loss), I get sort of…paranoid. Like one can BE paranoid about an issue that seems to run 24 7 in every element, aspect and goal of modern American Society.
Seriously, have they NO other examples?

As they say – it’s not paranoia if they’re actually after you.  Fat bodies, being fat, and stereotypes about being  fat are used to represent everything from  greed to laziness to capitalism and more.  Our bodies are freely used for whatever the negative metaphor, comparison, or representation of the day is.  As if we have no feelings about seeing people who look like us constantly used to represent everything bad in the world, or as if those feelings aren’t important.

Our bodies are not yours to photograph and throw all over the internet as a metaphor for anything (or as some bullshit People of Walmart nonsense.)  We are PEOPLE, these are our BODIES, and EVERY BODY deserves respect.

Of course we each get to choose how to deal with the oppression we face. For me, when this happens in person I’ve found that one of the most effective tools is to use confusion, acting like I don’t understand the comparison and making the person explain until the problem is obvious and they get too uncomfortable to continue.

When it happens online, I propose a little bit of simple at-home activism.  Every time you see fat people or being fat used to represent something negative, leave a comment like “Fat people aren’t yours for the metaphor-ing. Every body deserves respect!” If you want to take it one step further send an e-mail to the source of the story – tell them your personal story, send them this blog whatever, but let’s teach people that this behavior isn’t ok.  Also, I’ve found that this kind of activism can reframe this issue for me – now instead of feeling angry or hurt or ashamed when I see this happen, I can look at it as a chance to educate, and advocate for myself.

I am super excited to announce the 2017 Body Love Obstacle Course!

Last year 30 people participated in the first ever Body Love Obstacle Course. Some joined on the live calls, and some used the recordings on their own time. Based on their feedback, we’ve created two separate options – the BLOC Power Circle – an intense course that includes a series of live calls and is limited to only 10 people, and the BLOC e-Course which is self-paced and utilizes recordings. Both include the same curriculum and are coached by me, Jeanette DePatie, and amazing guest coaches.

Both are a step-by-step program that gives people the tools, coaching, and community to create a rock solid foundation of self-esteem and body love, and teaches the strategies and skills to leverage that to create the life you’ve always wanted.

Super Early Bird pricing is available during the pre-sale until December 15 so
get the details and register here! 

Note:  if you are a Danceswithfat member be sure to check your e-mail and/or the member page to get your $50 and $30 discount.

Like this blog?  Here’s more cool stuff:

Become a Member! For ten bucks a month you can support fat activism and get deals from size positive businesses as a thank you.  Click here for details

Book and Dance Class Sale!  I’m on a journey to complete an IRONMAN triathlon, and I’m having a sale on all my books, DVDs, and digital downloads to help pay for it. You get books and dance classes, I get spandex clothes and bike parts. Everybody wins! If you want, you can check it out here!

Book Me!  I’d love to speak to your organization. You can get more information here or just e-mail me at ragen at danceswithfat dot org!

I’m training for an IRONMAN! You can follow my journey at www.IronFat.com

If you are uncomfortable with my offering things for sale on this site, you are invited to check out this post.



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Sunday, 4 December 2016

Words Matter

“Sticks and stones can break my bones, but words can never hurt me” is a lie. To someone who’s being bullied verbally, as long as the bullying never crosses that line, it can be a helpful lie. You tell yourself words can’t hurt you, and reinforce that you aren’t defined by the bully’s opinion of you.  You don’t let their poison into your heart, and because you believe that words can’t hurt you, they lose some of their power.  You believe it, and you make it true.

But words do matter.  And truth matters.  There seem to be no consequences for malicious lies that get people killed, at least not to the liars themselves.  Fred Clark talks about this extensively—this fantasy game where right-wing Christians falsely accuse people of horrific evils so they can view themselves as the heroes of the story, nobly standing up to the Satanic baby-killers.  Today, a man walked into a restaurant and fired shots, because of the latest Satanic baby-killers lie.  No one was hurt, and he was arrested, but this problem is bigger than any one person.

I cannot help but think that there should be some legal consequence for such blatantly false and dangerous accusations, something like the criminal equivalent to libel or slander. And yet, anything like that would be used as a weapon against people speaking out against the incoming administration, probably far more than it would be used to charge people who made false accusations of child rape or murder and got people killed.

So, the only thing I can suggest is that we have to be willing to call a lie a lie, and be willing to stand up for what’s true.  The media, in particular, needs to get away from “critics say” and pointing out that an allegation was made without documenting that there was no shred of evidence associated with that allegation.  They might have to shy away from “lie” because that implies intent, which is tricky to prove, but there’s nothing wrong with “falsely claims” or “unproven allegations.”

We cannot be a post-truth society.  The human cost is too high.




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On Fatlicious Holiday Gift Giving 2016

‘Tis the season to spoil those you love, and yourself, with some fatlicious gifts. Here is my guide to fatlicious shopping for the 2016 holiday season. Treat yourself and those you love, and support fat people!

 

 

For the fatshionista

fat-necklace

Fat necklace from Fancy Lady Industries

 

copper-union-jumper

Alexa Jumper from Copper Union

 

choker

Queen Cartwheels Choker from Chubby Cartwheels

 

 

 

For the person on the go

murderofgoths-bag

Plus size bloggers tote bag from Murder of Goths

 

ipad-case

Naked fat ladies iPad case from Rachele Cateyes

 

 

For the seducer

strapless-bustier

Strapless Floral Bustier from the Intimates II Collection Chubby Cartwheels

 

curvy-as-hell-briefs

Curvy as Hell briefs from Nicky Rockets

 

 

For the collector

power-badge

Fat the Power badge from I Heart Gallery

 

faith

Faith from Valiant Comics

 

fat-mermaids

Fat Mermaids: A collaborative charity zine by Paige Hall (not available at the moment – but hopefully will be again because this is a MUST for any fat art collector!)

 

 

For the weekend

fat-artists-tshirtdecolonise-tshirt

Fat Artists Rule T-shirt and Decolonise Body Love T-shirt from Nalgona Positive Pride

 

teamstillfat-t

#TeamStillFat from #FreeFigureRevolution

 

fat-and-thriving

Fat & Thriving from Ready to Stare

 

 

For the scholar

Fat Activism

Fat activism: A radical social movement by Charlotte Cooper

 

pedagogy-reader

The fat pedagogy reader: Challenging weight-based oppression through critical education edited by Erin Cameron & Constance Russell

 

 

For the home

swirls

Candy Bodies art print postcards by Elsa Underwood Art

 

Calendar 2017.jpg

Adipositivity Project calendar 2017 from Substania Jones

 

fatasfuck

Fat as Fuck embroidery from HerMadeCo

 

 

For the kid in all of us

bigfatlittlecolouringzine

The Big Fat Little Colouring Zine by Natalie Perkins (this is available as a printed zine or a PDF)

 

fat-activism-colouring-book

Body Love: A Fat Activism Colouring Book by Allison Tunis

 

superfat-crop-top-girl-gang-colouring-zine

Superfat Crop Top Girl Gang Colouring Book Zine by Rachele Cateyes (get all four!)

 

 

For the lotto winner

ditto-dress

Beth Ditto Double Bubble Dress

 

 

 

Previous fatlicious gift giving guides

Fatlicious Guide 2015

Fatlicious Guide 2014

Fatlicious Guide 2013

Fatlicious Guide 2012

Fatlicious Guide 2011

 

 

 



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Friday, 2 December 2016

Fatphobia Claims Another Life

Bully Free ZoneToday’s blog is pretty intense – content warning for discussion of bullying, harassment, and suicide.

Brandy Vela sent her sister Jackie a text that said “”I love you so much, please remember that, and I’m sorry for everything.” Then she took her own life.

Brandy was the victim of cyberbullying.  According to Jackie:

“People would make up fake Facebook accounts and they would message her and she wouldn’t respond and they would still come at her…They would say really, really mean things like, ‘Why are you still here?’ They would call her fat and ugly. She was beautiful, absolutely beautiful; the only thing people could find to pick on her was her weight.”

Jackie says her sister changed her phone number and reported the bullying to police, but was told they couldn’t help her.

“They couldn’t do anything because [the suspects] used an app and it wasn’t traceable and they couldn’t do something until something happened, like they fight,” Jackie said.

This is a story that far too many fat people on the internet know far too well.  Anonymous cowards who use the tools that the internet provides, and the fact that laws haven’t caught up with technology, to do things online that would be illegal if they did them in person, or even using traditional mail.

If you’re one of these bullies and you’re reading this, know that you killed Brandy Vela.  You have blood on your hands and it will never, ever wash off.  Walk away from this now, find someplace to hang out other than online hate forums, find something to do that isn’t mistreating fat people. You can walk away, and you should.

If you are the victim of these people, please know that you are not the problem – they are. You are fine, your body is fine, you do not deserve this – you never did, and you never will.

Friends and family are honoring Brandy’s life: Post-it Notes filled with loving words cover her bedroom, and blue hearts are tapes all over the hallways in her school.

I’d like to suggest another way to honor all of those who have been victims of cyberbullying. When you see trolls online putting fat people down, trying to keep us from living the lives we want, trying to keep us from telling our stories and creating community, trying to make sure that we can’t even exist in the world for a moment without constant shame, stigma, bullying and harassment, remember that while it’s easy to write them off as sad and pathetic (and they certainly are both) they are also something else – they are murderers. Brandy is sadly not the first or last to fall prey to them, and we should hold them accountable.

Stories like Brandy Vela’s break my heart.

Casualties of the

horribly conceived and horrifyingly conducted “war on obesity” and the cyberbullies who all too eagerly enlist themselves in the  army of hate.

If you are a fat person, know that you are amazing. In the face of a crushing amount of bullying and stigma, in the face of the government recruiting our friends, families, and employers to fight a war against us, in spite of the intense oppression that tries its best to crush us, that we keep living our lives is a testament to our incredible strength.

And yes, it’s ok to be fat.  And if they want a “war on obesity” then we will damn well give them one. And know that you can’t be strong all the time so if you are feeling low – if you fear that you may become a casualty of this war – reach out around the fatosphere, and let’s be here for each other.

In a world where waking up as a fat person and not hating ourselves is considered an act of rebellion, I’m proud to be a rebel. In a world where refusing to spend all of my time , money and energy trying to manipulate my body size is considered a crime against society, I’m proud to be a criminal. In a world where loving my body is an act of revolution, I’m proud to be a revolutionary.

Fuck the trolls, fuck the cyberbullies, and fuck the “war on obesity.” Live loud and proud my fellow fat people, because we are nothing short of extraordinary.

Like this blog?  Here’s more cool stuff:

Become a Member! For ten bucks a month you can support fat activism and get deals from size positive businesses as a thank you.  Click here for details

Book and Dance Class Sale!  I’m on a journey to complete an IRONMAN triathlon, and I’m having a sale on all my books, DVDs, and digital downloads to help pay for it. You get books and dance classes, I get spandex clothes and bike parts. Everybody wins! If you want, you can check it out here!

Book Me!  I’d love to speak to your organization. You can get more information here or just e-mail me at ragen at danceswithfat dot org!

I’m training for an IRONMAN! You can follow my journey at www.IronFat.com

If you are uncomfortable with my offering things for sale on this site, you are invited to check out this post.

 

 



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Wednesday, 30 November 2016

Underpants Rule

Underpants RuleThis is one of those annual tradition posts – it’s the Underpants Rule and it is pretty simple: when it comes to personal choices, everyone is the boss of their own underpants. So, when it comes to personal choices, you get to choose for you and other people get to choose from them and it’s not your job to tell other people what to do and it’s not their job to tell you what to do. To illustrate, if someone is considering saying something about personal choices that starts with

  • People should
  • Everyone ought to
  • What people need to do
  • We should all
  • Nobody should
  • You shouldn’t
  • blah blah things that have to do with underpants that aren’t yours blah blah

then there is a 99.9% chance that they are about to break The Underpants Rule. Of course telling you that you should follow the Underpants Rule is, in fact, breaking the Underpants Rule which is pesky, so let me instead make a case for the Underpants Rule and then you can make your own choice.

I chose a Health at Every Size practice (knowing that health is not an obligation, barometer of worthiness, or entirely within our control)  because I am a fan of research, logic and math.  I think that the research clearly shows that a HAES practice gives me a much better shot at supporting my health with way less downside risk than a weight loss- based health practice.

There are people who think the exact opposite of that.  I know that because they come here and tell me so – they say that I should make a different choice.  This blog is my little corner of the internet.  It exists only because I created it and I am thrilled to pieces that people enjoy reading it, that people get inspired by it, that it gives people information to make choices etc. I try very hard to make sure that I always follow the Underpants Rule and never tell anyone else how they have to live when it comes to their personal choices, and yet people come here and try to tell me how to live when it comes to my personal choices.  That’s annoying.

For this reason, I would never go onto someone’s weight loss blog and tell them all about Health at Every Size and quote research as to why I think it’s a better choice.  Those are not my underpants.

I do not enjoy (or believe them) when people tell me that I need to become smaller to be attractive.  Therefore I would never say that thin women need to become larger to be attractive.  Besides the fact that I don’t believe it, those are not my underpants. (Not to mention that the path to high self-esteem is probably not paved with hypocrisy so doing to someone else exactly what I don’t want done to me seems ill-advised.)

The “War on Obesity” is an underpants rule breakdown on a massive scale. A group of government, public and private interests (with various profit and political motivations) has chosen a group of people who are identifiable by sight and is now trying to tell us everything from how we have to prioritize health, to the path we have to take to become healthy, to how our bodies have to look.  Who died and made them Underpants Overlord?  Nobody. (And another year has gone by and I’ve still not received my official fat person pony.)

My metaphorical underpants and my actual underpants have something in common:  if I want somebody else in them, that person will be among the very first to know.  I have definitely not invited the executives at HBO, Kaiser Permanente, the government, or the diet industry into my underpants.

Over the years, there have been some misunderstandings about the Underpants Rule – mostly confusion about what is and is not covered, I wrote about the limitations of the UR here.

Now, I’m not telling what to do (cause, you know, Underpants Rule) but I’m suggesting that if you don’t like it when people attempt to be the boss of your underpants, then maybe take a pass on trying to be the boss of someone else’s.  I’m fairly certain that “Do unto others exactly what you don’t want them to do to you” is the brick rule or the pile of crap rule or something – at any rate a LOT of steps down from platinum and gold.

Remember, you are forever the boss of your underpants – occupy your underpants (with a nod to reader Duckie for that phrase)! I’m going off to see if there is a Guinness World Record for number of times the word underpants is used in a blog.

Underpants. Underpants. Underpants.

Underpants.

Under…

…pants.

Like this blog?  Here’s more cool stuff:

Become a Member! For ten bucks a month you can support fat activism and get deals from size positive businesses as a thank you.  Click here for details

Book and Dance Class Sale!  I’m on a journey to complete an IRONMAN triathlon, and I’m having a sale on all my books, DVDs, and digital downloads to help pay for it. You get books and dance classes, I get spandex clothes and bike parts. Everybody wins! If you want, you can check it out here!

Book Me!  I’d love to speak to your organization. You can get more information here or just e-mail me at ragen at danceswithfat dot org!

I’m training for an IRONMAN! You can follow my journey at www.IronFat.com

If you are uncomfortable with my offering things for sale on this site, you are invited to check out this post.



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Monday, 28 November 2016

Corrections to E’s Story

I have to make a couple of corrections to this post from two months ago. First, C wasn’t sick for decades; it was several years, but not decades.

The second correction is a pleasant surprise: E is doing better. She’s regained some weight, she has a better attitude toward food, and she seems generally more positive. She’s still lost some memory and some mental acuity, and she still can’t walk, but I’m feeling more hopeful than I had been. Let’s hope the positive trend continues.




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