11 New Ideas in The Science & Culture of Fat

In which I rundown things that happened this week and are awesome in the science and culture of fat.  Props to my friend Elizabeth for sparking the idea for this entry and also sending some of these really neat things my way. 

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Two transformative blog posts caught my eye.  There is a beautiful, sad and strong essay from  Can Anybody Hear Me? on The "After" Myth:

I now weigh 117 – 120 pounds (depending on the day), and standing at 5-foot 6-inches, that measurement means that After is very, very here. But, before you congratulate me, dear readers…if I have any…and dear friends and family who I know follow this blog… I have to come clean with you: I don’t feel like I’m at After. I’m terrified of being at After. And, I don’t like that After is here.
— Can Anybody Hear Me?

From the delightful Mohria of Coil and Curve on Why Fat Girls Should NEVER Show Their Skin, this entry is so good I squealed and cannot put the whole thing here but definitely keep tabs on this lady:

A Fat Girl should never show her skin because she might interpret it as being brave. We don’t need Fat girls running around feeling brave. We don’t need Fat girls thinking that they have to be brave to be themselves. We don’t need Fat girls thinking that they have to be brave to show their skin. There shouldn’t be a bravery that comes along when others are sure to ridicule and humiliate you.

A Fat Girl should never show her skin because she might make those around her uncomfortable with the power it gives her to not give a fuck. She doesn’t give a fuck because nobody should give a fuck. It’s no secret that she’s fat. If the whole world can see that she’s fat why then must she hide it? Who is she hiding it from? Why is she hiding it? Why are we making her hide it?
— Mohria, Coil and Curve

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From the science world, two Canadian physician bloggers are worth a follow:  Dr. Sharma of Obesity Notes and Dr. Freedhoff of Weighty Matters.  I love this picture from a recent post of Dr. Freehoff's:

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Curse my upcoming exam, I could not attend the 4th Canadian Obesity Summit in Toronto last week.  If you are or work with people that experience obesity, there are a ton of useful ideas that will pop up as free content on the websites from the 2015 and also the 2013 Summit.  Elizabeth attended and she said it was totally enlightening.    

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I love this wicked cool diagram called the shiftn Obesity System Influence Diagram.  The next time you find yourself looking at someone that is overweight or obese and wondering "how did they let this happen?" think more about "how did we let this happen?"  The determinants of obesity are similar to and as complex as those of poverty.

The firm that designed the map and did the foresight work around what obesity looks like in our world did so at the request of the UK Government.  Here is another version of the map from them.  And here is the report that was produced as a result of this collaboration

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And I've done the scouring of the high impact journals that publish research on health, obesity and nutrition to bring you a curated, readable summary of what the big shot scientists are looking at right now in fat science:

From April's Clinical Obesity

  • Those crazy Danes: Danish researchers looked a the sleep cycles of hundreds of children and compared them with the moon cycles (i.e. full moon, new moon).  They found that the kids moved a little less, slept a little more and were a little bit more insulin resistant (meaning less able to break down sugar, and more likely to store it as fat) during full moons.  They have no idea why they found what they found. Bottom Line: I have no idea. 
  • So, you've just done 45 minutes on the elliptical while watching HGTV and you decide to avoid stairs for the rest of the day because you worked out, you're good to go.  This study wondered, "what if people actually move less in their regular life when a doctor prescribes exercise?"  Some of the studies say yes and others say no.  Bottom line:  You probably should move more than you think you need to move. 

From Obesity Reviews:

  • Super key point: Preventing weight gain is a bajillion times easier than losing weight.  One thing we know for sure is that sugary drinks are a key driver of weight gain, especially in kiddos. Bottom Line: Soda pop and juice will probably cause you to put on pounds in the long run. 
  • My intellectual home is in addiction medicine and nutrition.  But I hadn't seen this 2013 article from Obesity Reviews on whether or not food addiction is actually a thing.   I think it is.  We know that there is a lot in common between the brains of people who are larger and people with addictions.  The authors aren't so sure.  Food is made up of so many things that it's hard to be sure what exactly is the substance of abuse.  It's probably sugar, based on animal models, but it could be fat or sugar and fat together.  The authors point out that the vast majority of obese people don't demonstrate anything even close to food addiction of even binge eating disorder (BED) which is actually a real, known thing.  And also that some thin people have BED and other food addiction-ish behaviours.  But then what about withdrawal?  Where does that come in because that's one important feature of addiction to nicotine, booze, etc?  Food addiction is gaining a lot of traction in lay communities and the media.  The authors propose in the review that it serves as "solace" for people who feel that their relationship with food is totally messed up.  But there is no abstinence when it comes to food.  I am keen to see how this research moves forward.  Bottom Line:  Lots of people think food addiction is a thing but the evidence isn't mature enough to tell.  Suspend judgement for now.

From April's International Journal of Obesity, which was dedicated to babies and wombs:

  • There is a lot more to know still but probably what happens in the womb when a baby is growing is quite related to obesity in those kids down the line.  There is probably also a link to diabetes and high cholesterol.  Bottom Line:  If you're pregnant, talk to your doctor about normal weight gain in pregnancy.  It is much less than you think.  
  • This is for all the wannabe dads out there!  Looks like what happens before baby is conceived also matters.  These very smart people looked at whether genes that we think are related to obesity were turned on in the babies born to obese and non-obese couples.   When I say 'turned on' I mean that they were methylated which is a form of activation that amps up the activity of those genes.  Looks like Dad's weight was important in determining whether the obesity genes were turned on in the new baby.  Bottom Line:  Both mom and dad should be trying to improve their health and reduce their BMI to under 30 to help their spawn prevent obesity.  
  • I am screwed.  I love coffee.  These terrible people looked at women who drank no caffeine, some caffeine and a decent amount of caffeine during their pregnancy and then followed them for 15 years.   The study was not one that we call 'gold standard' so the results definitely need to be replicated.  However, it was a pretty well done study where they cut through the statistical weeds and found that women who drank caffeine were a lot - like 87% - more likely to have obese kids than people who drank no caffeine.  It did not matter if the caffeine came from coffee, tea, soda pop or all three.  You've got to be kidding me.  There are some pretty good reasons why this is the case.  Caffeine stimulates the brain and baby brains are very susceptible to any small little hit and, in the end, it is the brain that regulates appetite and all hormones (i.e. insulin).  Bottom Line: If you're pregnant, stop drinking caffeine.  Maybe some other study will come a long and rescue all of us from 10 months of coffee abstinence but until then, godspeed

Not much from The New England Journal of Medicine on obesity or nutrition but two weeks ago, The Journal of the American Medical Association (JAMA) had a child focused issue:

  • North American kids are eating slightly less junk food and slightly more good food (fish, veggies) than before but still out-eat their peers around the world by a lot.  Bottom Line: Eat less bad stuff.  Eat more good stuff. 
  • This study looked at twins in Malawi, one of whom had malnutrition and one of whom didn't.  The healthier twins had good gut bugs more often than the malourished twins.  Bottom Line: Not totally clear but add it to the list of reasons not to request unnecessary antibiotics for your kids.  Antibiotics wipe out the good with the bad.  Sometimes this is ok.  Sometimes it isn't worth it. Ask your doctor. 

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Obesity, the app!

Obesity, the app!

Have you seen this  app?  Basically it will answer most of your questions about obesity science that matter for individual health. 

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In the end, we should all be doing as Michael Pollan does: Eat food.  Not too much.  Mostly plants. 

But even then, some of us will be larger than others.

Movement will help. 

 But even then, some of us will be larger than others.

And that's ok. You're ok.  I'm ok. We're ok. 

I will need to be reminded of this when I get pregnant and have to stop drinking coffee.