Blaming the fat chicks again

I used to work with someone whose daughter started menstruating at the age of eight. She told me at the time, "How do I explain to this kid what this thing that's happening to her means?"

It seems that her daughter is by no means an anomaly:

A new study finds that girls are more likely today than in the past to start developing breasts by age 7 or 8.

The research is just the latest in a flood of reports over the last decade that have led to concern and heated debate about whether girls are reaching puberty earlier, and why it might be happening.

Increased rates of obesity are thought to play a major role, because body fat can produce sex hormones. Some researchers also suspect that environmental chemicals that mimic the effects of estrogen may be speeding up the clock on puberty, but that idea is unproved.

The issue is of concern for both medical and psychosocial reasons. Studies suggest that earlier puberty, as measured by the age at first menstruation, can slightly increase the risk of breast cancer, probably because it results in longer lifetime exposure to the hormones estrogen and progesterone, which can feed some tumors.

Although the new study did not look at menstrual age, breast growth is also a sign of hormone exposure, and some researchers fear that early development might also mean an increased cancer risk.

Socially and emotionally, life can be difficult for a girl who has a child’s mind in a woman’s body and is not ready to deal with sexual advances from men and boys, or cope with her own hormone-spiked emotions and sexual impulses.

“Our analysis shows clearly that the white participants entered puberty earlier than we anticipated,” said Dr. Frank M. Biro, the first author of the study and the director of adolescent medicine at Cincinnati Children’s Hospital Medical Center.

Overweight girls were more likely to have more breast development, the study showed. But Dr. Biro said he did not think weight was the whole story. He said it was possible that environmental chemicals were also playing a role, and added that he and his colleagues were now studying the girls’ hormone levels and lab tests measuring their exposures to various chemicals.

“It’s certainly throwing up a warning flag,” Dr. Biro said. “I think we need to think about the stuff we’re exposing our bodies to and the bodies of our kids. This is a wake-up call, and I think we need to pay attention to it.”

Dr. Catherine Gordon, a pediatric endocrinologist and specialist in adolescent medicine at Children’s Hospital Boston, said that so far, most evidence showed that neither breast development nor menstrual age had changed for white girls of normal weight.

The new study included 1,239 girls ages 6 to 8 who were recruited from schools and examined at one of three sites: the Mount Sinai School of Medicine in Manhattan, Cincinnati Children’s Hospital or Kaiser Permanente Northern California/University of California, San Francisco. The group was roughly 30 percent each white, black and Hispanic, and about 5 percent Asian.

At 7 years, 10.4 percent of white, 23.4 percent of black and 14.9 percent of Hispanic girls had enough breast development to be considered at the onset of puberty.

At age 8, the figures were 18.3 percent in whites, 42.9 percent in blacks and 30.9 percent in Hispanics. The percentages for blacks and whites were even higher than those found by a 1997 study that was one of the first to suggest that puberty was occurring earlier in girls.

Here's the red flag that I see in this study: How was weight accounted for in this study? Was the weight distribution the same among these girls? Why are there no numbers indicated for the Asian girls?

There have always been overweight kids. I was a chubby kid and I started menstruating at the age of twelve, which was about average at the time. So if it's JUST about weight, why is it that chubby kids like me weren't menstruating at age eight in the late 1960's but they are now?

Given that no matter what an overweight woman goes to a doctor for, she's told to lose weight, can we really trust doctors to perform and analyze studies without weight bias? And why is it that weight is only causing early puberty NOW?

Because it's so much easier to blame Gluttonous Girls for their own early puberty and the potential health problems later on that may result from earlier pumping of estrogens into their system than to look at some of the environmental factors that corporate America is pumping into them...things like bisphenol A, which is in everything plastic with the recycling number "7" (which means it's not recyclable and ends up in landfills. BPA is in plastic food wrap, the inside of metal food cans,those ubiquitous plastic water bottles, and plastic food storage containers. Things like the chemical 4-MBC, which is found in the sunscreen that mothers now have to smear all over their kids to prevent skin cancer later on. Or bovine growth hormone, which is in American beef. Even something as seemingly benevolent as soy, which is in baby formula, mimics estrogen.

But why look at things that are profitable for the chemical and food industries as causes for girls finding themselves bleeding once a month at an age when they are simply not ready to hear what it all means, when you can simply blame them and their parents because they're fat?

Too bad you'll never see a woman feel comfortable doing this

A rebuttal to "Old Spice Guy":

Oh, sure, it's homophobic and sexist. And "Old Spice Guy" does have that winning combination of being ridiculously handsome, having great comic timing, AND perhaps the most musical name EVAH. But when Jennifer Hudson is shilling for Weight Watchers, I'm not holding my breath for Gabourey Sidibe to be the new face of Chanel.

(via Elayne)

I guess they'd rather we go naked

Considering the kind of flack that "women of size" get in this country if they dare wear anything that shows more skin than a burqa, I'm kind of surprised that clothing manufacturers aren't rushing to make things we want to wear so we don't do things to offend the populace like dare to leave the house in tank tops and capris on hot days.

Or perhaps they buy all the studies which say that if you're a plus-size woman, you're going to be unemployable and sexless. I don't claim to speak for every woman who's above a size 0 (which seems to be the benchmark for "normal size" these days, but I have a job that pays well, and so do other larger women I know. We have disposable income, and we like to have clothes that go beyond muumuus and sweatpants to wear to those jobs. I had one of those traumatic three-day regulatory meetings in which every aspect of your work is scrutinized this week, and for two of them I showed up in natty pinstripe pantsuits in two colors. That was the only colors they had or I would have bought six of them. You know how hard it is to get a suit when you're a 4'10" size 16? But these suits are awesome; they make me look as if I'm ready to audition for the next road company of Guys and Dolls:

Right now I'm in a pair of white cotton crop pants and a tank top. You don't like my upper arms? Don't look at them. It's friggin' hot.

For some reason, the New York Times, home of aging high school mean girl Maureen Dowd, decided that they should run a piece today on the shocking realization that fat women wear clothes too:

Corseted into a size 18 white denim dress, wearing heels that made her about 6-foot-2, Gwen DeVoe, a former model and fashion-show producer, stepped onto a runway in Manhattan this week and made a pitch to retailers for the plus-size woman.

Those stores that don’t carry bigger sizes? “Shame on you, baby, shame on you,” Ms. DeVoe said. “Every curvy girl that has a dollar is willing to spend that dollar.”

So retailers are realizing.

Sounds good so far, right?

Well, here come the killjoys:

That same day, a division of the Centers for Disease Control and Prevention reported that 28 percent of the adult population was obese last year, the highest percentage yet. Almost two-thirds of American women are either overweight or obese, according to the most recent CDC figures.

And the connection here is....what? That we should just go naked? Smokers burn holes in their clothes. Should THEY go naked too?

My mother is going to turn 83 next week. She has been substantially overweight for much of MY lifetime. She also is a 20-year lung cancer survivor and she's still smoking. She worked into her sixties and had two husbands. Did I mention her 83rd birthday is next week? You can send her good wishes in the comments; she'll read them.

Now what was all that about the fat chicks again? Oh, yes:

Although Americans have grown steadily heavier in the last decade, women’s plus-size clothing still makes up only 17 percent of the women’s apparel market today, according to NPD. There just is not much supply or variation in plus-size clothes for women to buy, said Marshal Cohen, chief industry analyst at NPD. And the big retailers have mostly stayed away.

Cost is one issue. Plus-size clothes are more difficult, and expensive, to make than more traditional sizes. Material can be the largest portion of a garment’s cost — up to about 60 percent — and larger sizes require not only more of it, but sometimes different production processes.

“Its not just about how much fabric is required,” said Deepa Neary, a retail consultant at A.T. Kearney, a consulting firm. “You’re actually using wider bolts of fabric, and that sometimes requires special machinery to produce the garments. You often don’t get to pass that on to the consumer, so your margins are not as high as the regular-size clothing.”

And with limited floor space, retailers say it’s hard to display, say, blouses from size 0 to 24. So the plus market “unfortunately gets treated like an exile,” said Kathy Bradley-Riley, senior vice president for merchandising at the trend forecasting firm Doneger Group.

Given those difficulties, some companies have pulled back on plus-size offerings. Old Navy and Ann Taylor stopped selling plus sizes in stores in the last few years, and now sell them only online. Liz Claiborne, which still sells some plus-size clothing, shut down its plus-size line Elisabeth, along with Sigrid Olsen, which carried larger sizes. It sold Ellen Tracy, which also had a plus-size offering. But given the strong sales in the sector more recently, and women becoming ever more overweight, some companies are giving the plus-size market a second look.

Yes, because a size 14 or a size 16 pair of pants means you have to have a store the size of your average Wal-Mart just to hang one pair of them. And there's SO much more fabric. If you've ever made your own clothes, you know just how ridiculous the "lots more fabric" and "lots more space" claims are.

This link is to a Simplicity pattern for a simple wrap dress. I chose a wrap dress because it's a style that just about anyone can wear. This pattern comes in sizes 8, with a 31-1/2" bust and 33" hips to 24, with a 46" bust and 48" hips. For a size 8 you need 1-5/8 yards of 60" wide fabric. For a size 24 you need 2-3/8 yards of 60" fabric. Even if the fabric is twenty bucks a yard, you only need a yard more fabric for a size 24. If you are a size 16, you only need 1/4 yard more fabric than the size 8 does. At twenty bucks a yard, that's five dollars more.

Until this country starts ridding the food supply of pesticides, chemicals, corn syrup, artificial crap and processed "food-like substances", and stops this idea that working 80 hours a week is somehow a good thing and starts giving workers six weeks of vacation and an eight hour day like European countries have, so that we can eat leisurely meals of fresh food; until there are bike paths so that you don't take your life in your hands if you want to bike to get a quart of milk instead of taking the car, until we know just what it is in plastics and chemicals that's not just making people fat, but keeping them that way, can we please just shut the fuck up about other people's weight and let us get dressed already?

Can we please stop putting people into food boxes?

Amanda blogged the other day about a University of Washington study showing that people who shop at low-end supermarkets tend to be more obese than those who shop at high-end markets like Whole Foods.

There's this thing going on in the progressive blogosphere, where we think about things like this, that the quality of what people eat is solely based on socioeconomic status, and that because we are good little progressives who go to gyms and read labels and go to local farmers' markets, and walk to the market that's a mile away to get a half-gallon of organic instead of getting into the car. We want to fight the good fight about getting things like fresh produce into low-income neighborhoods. All these are worthy things to do and worthy goals, but while embarking on a quest to make the perfect loaf of bread might make good fodder for a book, how many of us, even at higher income levels, have time for this?

One of the things that grieves me about the schedule I currently keep is that I feel sometimes as if I don't even know how to cook anymore. It isn't that I don't like to cook; I enjoy cooking. I'm a good cook. But when I'm up at 5 AM, out the door by 7:15 at the latest, and don't get home till 7 PM most nights, who the heck has time?

Mr. Brilliant and I eat dinner together most nights. It's important, I think, that we do this, because we really don't get much time together during the week. Just because we don't have kids doesn't mean that "together-time" isn't important. It would be very easy to tell him to just get lunch instead (since he tends to only eat once a day) and I'll get one of the healthy options at the company cafeteria, and the hell with it. Mr. B isn't a cook. He doesn't much like to cook. But because he gets home much earlier than I do, the cooking, such as it is, falls into his lap. He can grill things, and saute some frozen green beans in garlic, and make pasta with meat sauce. I taught him how to halve a pint of grape tomatoes, saute them in garlic, toss in some frozen chopped spinach and a splash of white wine and serve it over some packaged tortellini. But frankly, for the most part, Trader Joe's has really saved us on weeknights. The problem is, it gets a bit dull after a while. And while Trader Joe's food may be less processed than some others, it's still packaged food. It's multigrain pilaf in a pouch and pre-sliced roast real turkey with gravy and mashed potatoes with the aforementioned green beans; it's their pork roast florentine and prepackaged salads. So while it's better than eating Kraft macaroni and yellow powder and chicken nuggets and frozen non-food, it's still not something you made fresh.

On weekends we usually go out, so that we both get some time off. And again, it's being able to sit at a table together and chat and enjoy a meal. Sometimes on a nice evening we get takeout from the Greek place or thin-crust pizza and go sit in the park. Or we go here, where the we get plates of whole wheat linguini with chicken, broccoli rabe and fresh tomato. Or any of a number of places. The biggest minefield is the Tom Sawyer Diner, about which I've written before, which has amazingly good food, but if you stray from the salads, the excellent chicken souvlaki, or the surprisingly fresh and well-prepared seafood, you're likely to end up with something like the "Tom's Mex", which is a 15" plate piled with chili & cheese nachos, slices of chorizo, taquitos filled with con queso, 4 grilled shrimp, cheese quesadilla wedges, and for some strange reason, nuggets of what appear to be breaded fried macaroni and cheese. It's a heart attack on a plate, even if a well-prepared one.

So I navigate these places, choosing the fish and the whole wheat pasta and the bifteki, which is less meat than the gyro, and the veggie pizza. But it's still not the quinoa salad with organic arugula and fresh bell pepper that I might make if I had the time and if I didn't feel that on the weekends I just want to clean my house and otherwise slack off.

So where I'm going with all this, is that Amanda makes the point that cooking is often time-consuming, requires advance thought, and is difficult for some people -- even those who are not low income, to plan and prepare fresh meals week in and week out for twenty or thirty or so years. I'd love to clip recipes and sit with the grocery circulars and plan meals for seven days a week and lovingly prepare them at my leisure. But when you're in the kitchen at 8:30 at night chopping carrots and onions so that you can throw it in the crockpot inthe morning before you leave at 6:15 AM for a 7 AM conference call, you're going to start answering the siren song of Trader Joe and Tom Sawyer ever-more-frequently.

While it's all well and good to have the goal of eating locally where possible, and providing access to better-quality food for low income neighborhoods, we also have to look at the high-stress lives of most Americans. Either we are working ourselves to death in jobs we already have, sometimes multiples of them, or we are out of work and have gnawing terror of the future. Either way, we're not not making the quinoa salad.

Progressives can be douchebags too

Exhibit A: Chris Ryan and John Aravosis of Americablog, about the Kevin Smith/Southwest fracas:

This isn't discrimination at all. The only person being discriminated here would have been the passenger sitting next to Smith who paid full fair but had less space. It's true that most airlines have reduced the available space for passengers and at the same time, the size of Americans has increased.

If he already knew he needed to buy a second seat, his tantrum makes no sense. His twitpic attempt at humor noticeably avoids showing how he fit into his seat. For his neighbor on the flight, I doubt they would receive a discount due to the over sized passenger spilling into their already cramped space. Average sized people or small people don't receive any special benefits for taking up less space, do they? Even after Southwest apologized, Smith still blasted them. They'd be better off without this guy as a customer.

So what do you guys think?

NOTE FROM JOHN: I fly a good deal, and have sat next to someone obese before. I had to pull my left arm over to the right, with my elbow half way to my navel, the entire flight, so as not to be playing snugly with the guy to my left. It was very disconcerting, and physically uncomfortable, having someone else basically sharing your seat. I appreciate that we should not judge people by their weight. But I'm also not so sure that treating obesity as if it's a minority status is correct either. If your metabolism is screwed up, fine. If you eat too much crap, then I have less sympathy for you.

I wonder how John is going to tell the difference between those of us who are descended from shtetl peasants and whose bodies have always believed the famine is right around the corner so we'd better store every morsel we eat as fat, and the ones who eat too much crap. Does he have X-ray vision so he can see into our stomachs and see the egg white and steamed veggie omelet I have for breakfast most mornings and also see the Denny's Grand Slam breakfast in the belly of someone else? That's quite a gift. If he can do that, perhaps he should give up this blogging thing and start working as an airport security scanner.

Now, I like Americablog. I read it daily and it's a good source of news I may not see elsewhere. But at times like this, I get this close to scrubbing it from my blogroll and never linking again. The last time this happened was the last of Chris Ryan's now tiresome screeds essentially opining that all baby boomers should be lined up and shot. It's just another example of how you don't have to be a wingnut to be a dickhead.

Similar sentiments from so-called progressives from the comments over at Salon:

Hey Kev, you're a lardass and it's not the world's fault. Hire a semi to haul your fatness around. And spare the rest of us having to sit next to you and next to you and next to you.

They should travel by ox cart or something. I mean really. Do they need to inflict their smelly fatness on everyone else?

I've been next to fat slobs on airplanes and it's not fair. They are in your space and totally oblivious to it. If you are in halfway decent shape, then you couldn't possibly need "all that" space, now could you?

If I were dictator I would demand they be harvested for their fat, Tyler Durden like. All that fat is energy and can be turned into clean diesel.

Kevin Smith and Kate Harding cheek by jowl in coach on a trans-Pacific nonstop. I would love to see these walking externalities get a load of their own medicine.

Sorry, I don't want someone's fat touching me. It's just nasty, and in many cases there are some hygiene issues too.

I don't want someone else rubbing up against me, and if people can't fit in a seat without rubbing (or blobbing onto) the person next to them, then they need 2 seats. Airlines should make it easier for the Obese to purchase 2 seats, but it has to be done.

10 bucks says that last guy spreads his legs out when he's on a plane or bus.

It's interesting, though, to see that the kind of sheer hatred you see spewed in so-called progressive corners every time someone fat wants to be treated like a human being. You see the kind of language that if a wingnut used it against someone who's black, or disabled, or -- dare I say it -- RETARDED -- we would be screaming bloody murder. But it's perfectly OK for these same progressives to tar everyone who is their idea of overweight with the same kind of stereotypical broad brush that they'd be appalled to hear their friends use when talking about anyone else.

Wingnuts may have a higher douchebag quotient than we do, but we have our share too.

If your hips are more than 17" wide from hipbone to hipbone, forget about flying Southwest

I guess Southwest doesn't want anyone who isn't anorexic to fly with them, because 17" really isn't all that wide a seat for even a moderately-sized person. As noted in the link, New York City subway seats are wider than that.

But now Southwest's "Fatties Buy Two Seats" rule has snagged a famous person -- one who knows very well how to use the intart00bz to make things go viral:

Filmmaker Kevin Smith, fresh from delivering a speech at the Macworld Expo in San Francisco, unleashed his fury on Southwest Airlines after the pilot on Smith's flight from Oakland to Burbank ejected him for being "too fat to fly" Saturday evening.

"I'm way fat, but I'm not there just yet," Smith wrote on his Twitter.com account after the incident, adding that he was able to lower both arm rests at his seat. "I broke no regulation."

Most of us have sat next to people who "spill over"; and you don't have to be all that big to do that in an airline seat. As airlines pack more seats into their planes, making them ever-smaller in an effort to squeeze in more paying customers, it's ridiculous to make a seat in which only an anorexic fashion model can fit comfortably and then tell everyone else they have to buy two tickets.

It's really a shame, too. I have family in North Carolina, and my non-driving options are dwindling. I won't fly Continental down there anymore because their Newark-to-Raleigh route is run by Colgan Air -- those wonderful people who paid their pilot on that infamous Newark-to-Buffalo plane that crashed last year $25,000 a year and the co-pilot $15,000. No one else flies nonstop. I'd planned to take Southwest out of Philadelphia next time, but now I'll be damned if I give them a nickel of my money. So now the choice has dwindled down to Amtrak, which means I have to be in downtown Newark at 7 AM, or driving either our seven-year-old Corolla or our nine-year-old Civic.

Or just stay home, which is turning into the best option.

More from Kate.

So of course the answer is simple: Lose weight until a doctor finds you attractive

From the "Gee, ya think?" file (and Melissa):

It's shocking, but it's true: Being a woman who's more than 20 pounds overweight may actually hike your risk of getting poor medical treatment. In fact, weighing too much can have surprising -- and devastating -- health repercussions beyond the usual diabetes and heart-health concerns you've heard about for years.

Recent studies have found, if you are an overweight woman you:

• May have a harder time getting health insurance or have to pay higher premiums

• Are at higher risk of being misdiagnosed or receiving inaccurate dosages of drugs

• Are less likely to find a fertility doctor who will help you get pregnant

• Are less likely to have cancer detected early and get effective treatment for it

What's going on here? Fat discrimination is part of the problem. A recent Yale study suggested that weight bias can start when a woman is as little as 13 pounds over her highest healthy weight.

Think about that. Thirteen pounds over your "healthy" weight as defined by a medical community that quite admittedly hates you. You know what my "healthy" weight maximum is for my height? 105 pounds. You know when I weighed 105 pounds? In 1983, when I was starving myself and working out five nights a week. So I guess I haven't been entitled to have a doctor treat me like a human being ever since.

More:

Doctors have long known that obese women are more likely to die of ovarian and breast cancers, but when Schneider and her colleagues recently gave a group of overweight ovarian cancer patients chemotherapy based on their actual weights, they found that the women were as likely to survive the illness as thinner patients. "Doctors aren't intentionally under-treating overweight women," Schneider says. "We're just working with limited information."

I'm not so sure I believe that. We live in a "No fat chicks" society after all, why not consign all of us to die simply because they don't find us attractive.

More

When Celina Reeder, a 5-foot-5, 185-pound woman with a torn ligament in her right knee, was told by her surgeon she needed to stop eating so much fast food before he would schedule surgery, the Woodacre, California, woman was astounded. "I left his office feeling ashamed," she recalls. "And I don't even eat fast food! The more I thought about it, the madder I got. So I switched surgeons. Anybody who thinks doctors treat heavy women the same as thin women has obviously never had a weight problem. I really felt like my doctor didn't respect me."

She may have been right. University of Pennsylvania researchers found that more than 50 percent of primary care physicians viewed obese patients as awkward, unattractive, and noncompliant; one third said they were weak-willed, sloppy, and lazy. In addition, researchers at Rice University and the University of Texas School of Public Health in Houston found that as patient BMI increased, doctors reported liking their jobs less and having less patience and desire to help the patient.

Whether they know it or not, doctors' attitudes may actually encourage unhealthy behavior. Feeling dissed about their weight can make some women turn to food for comfort. "Stigma is a form of stress, and many obese women cope by eating or refusing to diet," Puhl says. "So weight bias could actually fuel obesity."

Studies have also found that overweight women are more likely to delay doctors' appointments and preventive care, including screenings for cancer, because they don't want to face criticism. "It can be frustrating to treat obese patients," admits Dr. Lee Green, M.D., M.P.H., a professor of family medicine at the University of Michigan in Ann Arbor. "I spend most of my time treating the consequences of unhealthy lifestyles instead of actual illnesses. People come in complaining of foot or knee pain, and I'm thinking, Do you not see that you're in pain because you're 60 pounds overweight? I don't say that, of course. I try to encourage them to lose weight."

Yes, they all do that. But not one of them has any good ways of how to do it and keep it off, given the way we live today.

I always use myself because I'm the best example I know. I'm a 4'10" tall size sixteen. I don't eat fast food. I have cut extra sugary things other than the occasional square of dark chocolate and an occasional small cookie almost entirely out of my life. I don't eat fried foods. You know what I don't do much of? Exercise. It's kind of hard to carve exercise time out of your day when you leave the house at 6:15 AM, get home at 6:30 PM, and need at least six hours of sleep and preferably at least seven. The new on-site gym ought to help that somewhat, provided that a) I can get to the equipment, and b) use it during the day so that I'm not arriving home at 8 PM, eating a small dinner and then going to bed.

Every now and then you read a research study about obesity that gives tantalizing clues about how it's about more than gluttony or sitting around eating doughnuts (something I don't even LIKE). There are studies about stress as a cause. But hey, working 70 hours a week isn't at all stressful now, is it? There are studies about how exercise doesn't do much if your diet is already reasonably healthy. There are studies about ghrelin. (Funny how WebMD is sponsored by Chex Mix, isn't it?) And yet every article about these studies ends with "But if you have X sensitivity, or X tendency, you may just have to watch your diet and exercise more than other people." It never, ever occurs to anyone that perhaps being what our society calls "overweight" may in fact be normal for some people?

I recently had a dermatologist tell me to go to Weight Watchers, a company that had $4 billion in sales in 2007. If Weight Watchers is so damn effective, how come it makes so much money? Nestlé paid a bundle for Jenny Craig a few years ago. Nutri-System's food is, from all accounts, horrible; and Medifast looks like a pyramid scheme. My local newspaper's advertising is lately leaning heavily towards gastric band practitioners. Exploitation of the overweight is big business, and as a result, there is little motivation to rid the world of fat people by making them not fat. Who'd pay for all this crap otherwise?

I recently had the idea of switching to a local gynecologist who specializes in weight issues with postmenopausal women. It sounded intriguing, since most of us who reach a certain age find that the perfect sine wave we once had for a waistline has flatlined. Then I read about the protocol she follows, developed by a doctor. I picked up a copy of said doctor's book, and it sounded sensible; sort of like the Sugar Solution books, but then I found out that this protocol also involves an off-label use of the diabetes drug Metformin. Now, I'm not a big fan of prescription drugs under the best of circumstances. This particular one can cause lactic acidosis, which can be fatal in up to 50% of cases. It may be a perfectly fine drug for diabetics, but with a risk like this for off-label use, well, thanks but no thanks.

The FDA has FINALLY issued a warming about BPA, a chemical in plastics that has been linked for some time to obesity, and which is ubiquitous in most household products and food packaging. Funny how the so-called rise in obesity coincides with increased use of BPA. But especially now that corporations can buy their own Senators and Congresspeople, how likely do you think it is that BPA will be further studied and possibly banned?

Yet no matter how many studies come out that indicate overweight is not always about gluttony and laziness; it can be about the crap that is spewed into the environment and that lines our food containers; it can be about trying to survive in a society in which jobs are few and when you have one, you want to hold onto it. It can be about any number of things, and yet the so-called medical community only has one thing to say to us: Stop eating and spend your life on a treadmill. After all, millions of hamsters can't be wrong.

Be a size 0 or be prepared to pay the price

Those of you who are regular readers of this blog are very well aware that I am, shall we say, a person of some girth. According to all possible charts, I am fat, and therefore this culture defines me as unhealthy, despite my perfectly OK cholesterol, my 120/80 blood pressure, and the kind of ridiculously strong genes that make me fortunate to have TWO living parents at the age of 54. These parents, and I hope they don't mind me revealing a bit about them in the name of Making a Point, are hardly paragons of Conventional Wisdom either.

My father is going to be 85 this year. He's overweight, he's sedentary, he doesn't exercise, and while he eats relatively well, he enjoys a good marbled steak with an appetizer of spinach artichoke dip as much as the next person. He has minor health problems, including a chronic illness that does not seem to be progressing and a replacement hip, but other than that, he's fine. He finishes the New York times crossword puzzle every Sunday. He and his wife are in a French club.

My mother (who has been widowed since 2000) is 82. She had lung cancer about 20 years ago. Yes, lung cancer. Do you know what the average 5-year survival rate for lung cancer is? 15%. Mom has made it for 20. She's still smoking. Yes, she has COPD and other health problems, but this is someone who used to smoke nonfiltered Camels, has been smoking since the 1940's, has been overweight much of the time, and is still kicking at 82, living with her feisty little dog. By the way, her husband was slim, active, ate well, did not smoke, and died at 75 of thyroid cancer.

So here I am, with this presumably equally strong constitution. But does any of that matter? Nope. I still get the "lose weight" lecture every time I go to a doctor, with the answer to "What do you suggest" always being "Weight Watchers", notwithstanding the fact that if Weight Watchers were so successful, why is it still in business, and why is my co-worker on her FOURTH ROUND THROUGH THE PROGRAM???

There are bloggers like Kate Harding who try to promote "health at any size", but because in our society we simply cannot take on things like processed foods and corn syrup and plastics which leach crap into our food that promote weight gain, and the stresses of either looking for a job or trying to hang onto one, what we do is blame the entire cost of health care on Teh Fatties.

It should also be noted here that I do not eat donuts. I do not eat Twinkies. I rarely eat cookies anymore. I never eat fast food. I've gone cold turkey from even low-fat ice creams. I don't like chips and Bugles and Chee-tohs and other "snack foods". I work usually 55-80 hours a week. I have been out from work sick five days in the last nine years. So the trolls who want to talk about me sitting on the sofa all day eating baby-flavored donuts can go ply your business somewhere else, because I WILL delete your comments.

I have fought this battle for as long as I can remember. I remember realizing I was fatter than other kids very early on, but my first humiliating memory was of being eight years old, never having gone ice skating before, and going to an ice skating birthday party for a "friend", where I ended up being shlepped around the rink by the birthday girl's older sisters, who talked THE ENTIRE TIME about how if I wasn't so fat they wouldn't have to do this. I wasn't all that fat, either. I look at my old high school yearbook now, the one from my junior year where I'm in the front of the homeroom picture, wearing a zebra-striped jumper I'd made myself that barely covered my ass, with black tights, and wondering how on earth that girl ever thought she was fat.

The only time in my life that doctors haven't given me the Lose Weight lecture was in 1983, when I went on Cambridge Diet -- a 300 calorie a day, allegedly "nutritionally complete" liquid diet that was guaranteed to make the weight just POUR off. I weighed 118 when I started. Sixteen weeks later, I weighed 105 -- a massive weight loss of thirteen pounds in four months. During that time, I was going to a health club five nights a week, where I took an hour aerobics class, followed by a half hour of weights.

Thirteen pounds in sixteen weeks. Even with all that. But I was at last a size six. For about five minutes. I had no tits, but I was a size six.

The minute I started eating any solid food at all, the weight started piling back on. You see, I met Mr. Brilliant during that time. And when you date, you go out for dinner a lot. And I would sit in restaurants pushing my food around the plate and going on crying jags that I didn't understand. When I did eat, I'd go home that night, but on my Jane Fonda Workout album and do an hour of aerobics in my apartment before going to sleep. Later on I knew what the crying jags were about. I WAS HUNGRY, DAMMIT. Finally, one day at the Feast of San Gennaro, Mr. B had had quite enough of this. It was either stop this madness with food or be crazy without him.

As I go further into middle age, I'm making small changes to how I deal with food and recognize things that I could do better. This year I've given up diet soda under the assumption that when you are used to having a sweet taste in your mouth all the time, it just makes you crave sugar. I realized that sometimes I eat too fast just because I want to get to the seconds, when I'm really satisfied with the firsts. As I mentioned on our sister blog, Disciples of Joe, we're trying to eat less meat.

I know from past experience that defining oneself as "good" or "bad" as a person based on what one eats is a sure path to sitting down with a half-gallon of Edy's French Silk and a spoon...even if one doesn't even WANT a half-gallon of Edy's French Silk. For many of us, the minute the word "diet" is used, we want cheesecake, even if we don't LIKE cheesecake. "Breaking the diet" is, in my opinion, a sane reaction to an insane situation, that insane situation being substituting boxes of frozen crap put out by food conglomerates for actual food that satisfies and nourishes. Small, incremental changes are much easier to make, and far more productive in the long run.

How many people, particularly women, do YOU know who are heating up tiny boxes of frozen crap for lunch every day because they gained weight over the holidays? Come back in a month and tell me how many STILL are. Then check and see how many bags of M&Ms they have squirrelled away in their desk drawers.

A few years ago, I went to the gynecologist I'd been seeing for 20 years. I always liked her because we talked about movies and she never gave me shit about my weight. She was pretty, and maybe ten years younger than I was, so she was just starting to get to that thing that happens around age 45 when you start noticing changes in your face and your body on a daily basis. That year she was going to her high school reunion, and had lost 40 pounds on "The Accubead diet." On this one, you go to this psychologist who gives you these accupressure beads to put behind your ears. Then you alternate days: On Day 1 you consume 2-1/2 cups of whole milk and nothing else. On Day 2 you consume a pound of vegetables and nothing else. Repeat and repeat and repeat. When you get hungry, you press the beads and it tricks your hypothalamus into thinking you aren't hungry. 20 ounces of full-fat milk is about 500 calories. That isn't all that much different from the Cambridge Diet I was on. So, thanks but no thanks. So after 20 years I had to find another gynecologist, because mine had gone through a midlife crisis and wanted to look good for her reunion.

This is madness.

Weight is more than just calories in, calories out. In 1983, I was expending far more calories than the 300 a day I was taking in with three 100-calorie water shakes every day, and I still lost less than a pound a week. Study after study debunks calories in, calories out, and the answer researchers always give is not that we are all different, but "If you metabolize slowly, you just have to work harder at it than other people." It can't possibly be that our bodies are doing what our own, unique, particular bodies do. No, we just have to starve ourselves and work out five hours a day, that's all.

Now, all this said, there ARE things I can do to be healthier. Now that I'm older, I do feel the effects of weight more often. But I think the weight I'd need to lose in order to not feel these effects is perhaps 20 pounds, not the fifty that the charts would have you believe. There are ways I can eat in a more healthy way, like making barbecue brisket a treat instead of a habit. They are putting in a gym at work, so I can move this body during the day -- something that's hard to do outside of work hours when you leave the house at 6 or 7 AM every day and most nights don't get home till 6:30 PM and you need at least 6-1/2 hours sleep.

But thanks to the Senate, health care reform won't care about these changes, and it won't care about your health. It's only going to care about broad-based numbers in a one-size-fits all; even if you're 4'10" tall and couldn't get down to 95 pounds even when you were 25:

A little-discussed provision of the Senate bill allows insurers to expand so-called wellness programs that allow insurers to penalize subscribers by hundreds—and even thousands—of dollars for not meeting certain "wellness targets," such as a particular cholesterol number, blood sugar measurement or body-weight target.

Remember all those Democrats pleading plaintively, in the face of Republican accusations that the GOP had been cut out of the health care debate, that actually they included many Republican ideas in their health care bills? Well, this is one of them. One of the pro-business innovations of the Bush administration was to introduce into health insurance regulations a provision allowing employers to offer loosely defined "wellness" programs that carry incentives for employees meeting certain standards of premium reductions of as much as 20 percent. Sounds like a pretty good deal, right? Sure, until you realize that there's no baseline for the original premium, meaning that, in reality, people who don't meet the standards are really carrying the burden of others' discounts and then some—paying as much as 20 percent more for a policy in which a family member's failure to meet a wellness target forces up the entire premium for that family's policy.

If you think that's a raw deal, consider the Senate health care bill provision introduced by Sen. John Ensign, the disgraced Republican of Nevada. Now that percentage of discount or penalty, depending on which end one finds oneself, can amount to a differential in one's premium to 30 percent, and eventually to 50 percent.

So what is "wellness", anyway? Is an anorexic with a BMI of 18 "well"? What about people with congenital high cholesterol? What happens to the livers of people who start taking Lipitor when they're ten? When will people not have to work 80-hour weeks to show how valuable they are to the company so they HAVE the time, and the energy, to take a walk, play tennis, do yoga, or other forms of exercise that don't feel like a chore?

Wellness is a laudable goal. We all want to be well, and it's to society's benefit that we be well (except to the extent that we cost more when we live longer). But wellness comes in all sizes and habits. And because the research community has never wanted to touch this fact, we are left with legislators who have plenty of time to use the Congressional gym telling the rest of us we just have to eat less and work out more. In 1983, I ate about as little as was possible, and worked out every day. I had no life, I was miserably unhappy, but I was thin. Perhaps a nation of misery is what they really want.

Credit where credit is due

It's hard for a good liberal like me to applaud Meghan McCain. After all, her father wanted to perpetrate perhaps the biggest catastrophe that could ever have happened to this country by putting the idiotic Sarah Palin one heartbeat (or moose shot) away from having her finger on the button that could bring about the apocalypse that Christofascist zombies like her so dearly want. But it wasn't McCain the younger that picked Sarah Palin, and I can hardly blame her for not going public and saying "Dad, what the fuck are you thinking?" And while I cringe every time she tries to paint her dad's party as a young, hip, happenin' bunch, there's one area where she has been applauseworthy, and that is in her attitude towards those whose only focus is her (and other women's) weight.

Apparently there was some fracas this week in which she put a photo of herself in somewhat revealing jammies up on Twitter. Like most women of some size (and Meghan McCain is only a size 10, for God's sake), Meghan McCain has a rather impressive Rack of Doom. Apparently, among some quarters, most likely the kind of sexually-repressed quarters that represent the part of the political spectrum to which her father belongs, having breasts, and not wearing a tent to cover them, makes you a slut -- at the same time as these very same quarters are no doubt alone in the bathroom with a copy of Juggs and a jar of vaseline. So McCain did some kind of Twitterish fightback, and now she has a blog entry about our society's attitude about women and weight at The Daily Beast that no matter how foul and despicable her father is, is worthy of applause from our corner of the blogosphere:

Here’s what I want to know: What is it going to take and how many women have to die from eating disorders until things like this Jessica Simpson cartoon and doctored Ralph Lauren ads end?

This is something obviously very close to my heart because I have been mocked for my weight as well. And I always hit back. My most infamous moment was telling Laura Ingraham to “kiss my fat ass” on The View a few months ago. But here is the reality—as my public profile has grown and people recognize me more and more, an unsettling anxiety has set in, something that has come as a surprise to me. Every time I am on television, give a talk, or have a picture taken, inevitably the weight comments follow. It’s a new part of my life and by far the most consistent. I have started speaking at colleges and was recently asked why the media is so obsessed with my weight. I didn’t have an answer but I did say that I could probably cure cancer and solve all the Republican Party’s problems, and people would still make fat jokes. I am strong and stay strong because I have to be. But I have seen too many of my friends suffer from eating disorders and have seen firsthand how it can quite literally ruin a young woman’s life.

[snip]

My weight is the great constant in my life, no matter where I am or what I am doing it is an issue that comes up. People approach me in public sometimes to talk about their own body-image issues and commiserate about the cruel treatment I receive. Whether or not the media wants to face this, I believe some women are less likely to speak out publicly about their political beliefs because they see the way I am talked about. Why would any woman want to speak out on television when the inevitable result will be a merciless critique of her physical appearance? God forbid she is larger than a size 4 or under 5 foot 10, because then the way she feels politically is irrelevant. I worry about the long-term damage this kind of weight obsession is doing. We are grooming a generation of women who are less likely to speak out about their beliefs because of the assault that comes on their physical appearance as a result.

Of course she then goes on to equate the treatment of Hillary Clinton, a woman in her 60's who has been subject to relentless hag/crone jokes since 1993 with the Rich-Lowry-sparkly treatment given to Sarah Palin, but McCain IS a young Republican after all, so you can't have everything.

But the fact that Meghan McCain has to be the poster child for young Republicanism (an oxymoron if I ever wrote one) doesn't obscure her larger point about how our society treats women who have curves instead of looking like 12-year-old boys.

I remember the kind of crap I used to read in newsgroups back in 1997-1998 when the movie Titanic had captured the public consciousness. It usually ran something along the lines of "Kate is fat and Leo is gay." I would note the interesting juxtaposition of these two concepts side-by-side. And I would remember the brilliant Bob Goldthwait bit about gay-bashing:

...and then I would try to remember something from my Formal Logic class in college, and came up with the conviction that anyone who wrote any variation of "Kate is fat and Leo is gay" must think that a woman should be built like a skinny 23-year-old boy. And following that with "...and Leo is gay", given that Leonardo DiCaprio at that time WAS a skinny 23-year-old boy, well, you do the math.

And so it goes today. Any male (and it's usually males) who makes jokes about Jessica Simpson's weight, or Kelly Clarkson's weight, or for that matter, Meghan McCain's weight, is telling us far more about himself than he does about the woman about whom he's "joking."

So presumably you can have blood pressure of 110/70 and low cholesterol, but if your BMI is over 25 you too can be denied health insurance

I have to admit, I'm kind of obsessed with the health insurance industry today. You see, I have Anthem Blue Cross/Blue Shield through my employer, and I am going for a colonoscopy tomorrow. (I wrote about my first one here.) I hate to be like that greeting card I have in my file waiting for my oldest and dearest friend to turn 50 which depicts an old man and his grandson on the front with the caption, "Let me tell you about my colonoscopy", and on the inside it reads "Welcome to the gross personal story years." But based on some anecdotal reading I've done, colonoscopy is one of the primary procedures where health insurers start to act up.

The facility where I have it done is an ambulatory surgical center. For a wuss like me, this place makes having this procedure tolerable. They wheel you in, they knock you out, and next thing you know, you're done. No pain, no fuss, no anxiety, no trauma. If colonoscopy is the best way to head off colon cancer at the pass by catching it early, or preventing it by snipping off benign polyps before they can turn cancerous, it's in everyone's, including insurance companies', best interest to make the procedure less traumatic. Instead, insurers are increasingly refusing to cover sedation for colonoscopy. Anthem is a subsidiary of Wellpoint, which has been denying coverage for colonoscopy anesthesia since 2005. Aetna, the other insurance-based option my employer offers, stopped covering it in 2007.

When I had my last colonoscopy, I was utterly batshit panicked about the procedure, including the sedation. I've never been a hospital patient, never so much as broken an arm. The reason I wrote that long piece after my last one was because I know there are many people like me who are terrified of this procedure. I know because I live with one, and have been unable to get him to go. Colon cancer is a lousy way to die. I remember a family friend dying of it in her 50s. She had a stomach ache for weeks, they opened her up and she was riddled with it. They closed her up, it spread to her brain and she died three weeks later. And it's relatively easy to prevent through screening. But just like outpatient mastectomies and drive-through caesarean section births, the insurance industry doesn't want to pay a penny now to save a dollar later. Perhaps it's because they know they aren't going to pay the dollar later.

Not so long ago, Rep. Alan Grayson said the Republican health care reform is "Don't get sick, and if you do, die quickly." It isn't just the Republicans; it's the entire insurance industry.

I'm lucky. I'm paid well and if the damn anesthesia costs, I can pay it...assuming they don't turn down the whole claim for some arcane reason that only they know. I pay $2800/year for this coverage, and my employer pays almost another $10,000.

I'm writing about this now because I'll be watching carefully to see what my insurer does with the bill for this. Stay tuned.

But that's not even the reason for this post. The reason is another example of how the fact that insurance companies can change the rules willy-nilly affects real people. And in this case, they want to put an infant on a diet:

Alex Lange is a chubby, dimpled, healthy and happy 4-month-old.

But in the cold, calculating numbered charts of insurance companies, he is fat. That's why he is being turned down for health insurance. And that's why he is a weighty symbol of a problem in the health care reform debate.

Insurance companies can turn down people with pre-existing conditions who aren't covered in a group health care plan.

Alex's pre-existing condition — "obesity" — makes him a financial risk. Health insurance reform measures are trying to do away with such denials that come from a process called "underwriting."

"If health care reform occurs, underwriting will go away. We do it because everybody else in the industry does it," said Dr. Doug Speedie, medical director at Rocky Mountain Health Plans, the company that turned down Alex.

By the numbers, Alex is in the 99th percentile for height and weight for babies his age. Insurers don't take babies above the 95th percentile, no matter how healthy they are otherwise.

"I could understand if we could control what he's eating. But he's 4 months old. He's breast-feeding. We can't put him on the Atkins diet or on a treadmill," joked his frustrated father, Bernie Lange, a part-time news anchor at KKCO-TV in Grand Junction. "There is just something absurd about denying an infant."

Bernie and Kelli Lange tried to get insurance for their growing family with Rocky Mountain Health Plans when their current insurer raised their rates 40 percent after Alex was born. They filled out the paperwork and awaited approval, figuring their family is young and healthy. But the broker who was helping them find new insurance called Thursday with news that shocked them.

" 'Your baby is too fat,' she told me," Bernie said.

Up until then, the Langes had been happy with Alex's healthy appetite and prodigious weight gain. His pediatrician had never mentioned any weight concerns about the baby they call their "happy little chunky monkey."

His 2-year-old brother, Vincent, had been a colicky baby who had trouble putting on pounds.

At birth, Alex weighed a normal 8 1/4 pounds. On a diet of strictly breast milk, his weight has more than doubled. He weighs about 17 pounds and is about 25 inches long.

"I'm not going to withhold food to get him down below that number of 95," Kelli Lange said. "I'm not going to have him screaming because he's hungry."

Speedie said not many people seeking individual health insurance are turned down because of weight. But it does happen. Some babies less hefty than Alex have had to get health endorsements from their pediatricians. Adults who have a body-mass index of 30 and above are turned down because they are considered obese.

The Langes, both slender, don't know where Alex's propensity for pounds came from. Their other child is thin. No one in their families has a weight problem.

This baby doesn't eat McDonalds. They can't put him on a treadmill. But this is where the utter lack of willingness to investigate environmental or other causes of obesity comes back to bite us. There's already evidence that widely-used chemicals contribute to obesity, but somehow I don't think there's going to be a whole lot of effort put into investigating this further. Too many industries might be hurt, and why look into real causes when you can talk the same old tired crap about fast food and laziness -- and then deny health coverage to an infant.

(UPDATE: Heh.)

Dispatch from the "Figure That Out All By Yourself, Einstein?" file

Anyone who's ever done the "diet and exercise" thing in the hope of getting and staying thin knows that for those of us who do NOT eat donuts and do NOT eat fast food and do NOT gorge on candy bars and can walk the 2.56 mile loop around the lake that ends in a 30-degree uphill climb in only a minute more than it took us 14 years and twenty pounds ago, the whole diet and exercise equation doesn't work.

But it's surprising to see it in a mainstream publication:

"In general, for weight loss, exercise is pretty useless," says Eric Ravussin, chair in diabetes and metabolism at Louisiana State University and a prominent exercise researcher. Many recent studies have found that exercise isn't as important in helping people lose weight as you hear so regularly in gym advertisements or on shows like The Biggest Loser — or, for that matter, from magazines like this one.

The basic problem is that while it's true that exercise burns calories and that you must burn calories to lose weight, exercise has another effect: it can stimulate hunger. That causes us to eat more, which in turn can negate the weight-loss benefits we just accrued. Exercise, in other words, isn't necessarily helping us lose weight. It may even be making it harder.

[snip]

Last year the International Journal of Obesity published a paper by Gortmaker and Kendrin Sonneville of Children's Hospital Boston noting that "there is a widespread assumption that increasing activity will result in a net reduction in any energy gap" — energy gap being the term scientists use for the difference between the number of calories you use and the number you consume. But Gortmaker and Sonneville found in their 18-month study of 538 students that when kids start to exercise, they end up eating more — not just a little more, but an average of 100 calories more than they had just burned.

If evolution didn't program us to lose weight through exercise, what did it program us to do? Doesn't exercise do anything?

Sure. It does plenty. In addition to enhancing heart health and helping prevent disease, exercise improves your mental health and cognitive ability. A study published in June in the journal Neurology found that older people who exercise at least once a week are 30% more likely to maintain cognitive function than those who exercise less. Another study, released by the University of Alberta a few weeks ago, found that people with chronic back pain who exercise four days a week have 36% less disability than those who exercise only two or three days a week.

But there's some confusion about whether it is exercise — sweaty, exhausting, hunger-producing bursts of activity done exclusively to benefit our health — that leads to all these benefits or something far simpler: regularly moving during our waking hours. We all need to move more — the Centers for Disease Control and Prevention says our leisure-time physical activity (including things like golfing, gardening and walking) has decreased since the late 1980s, right around the time the gym boom really exploded. But do we need to stress our bodies at the gym?

I've long had a theory that if a given individual's body is designed to store fat, and if extreme calorie reduction just makes it hang onto weight that much harder, burning more calories is just going to make your body demand more calories to compensate for what you're burning.

I enjoy a good, long walk. And I don't just stroll leisurely, either. Because I'm short, I've always had to walk fast just to keep up with other people. I feel better when I stay active; when I take the steps instead of the elevator (and yes, I can run up 2 flights of 21 steps each without getting winded). But I know full well that spending every hour I'm not at work in a gym is not going to turn me into a size two.

I wonder also how much of the health problems associated with obesity are because we are too afraid to go to doctors for anything, because every doctor in the world is going to tell us to lose weight without having any information whatsoever about how to do so successfully. When you've made it to the age of 54 without being thin, and you can work rings around people who are half your age, it's kind of hard to say that my energy level would be better if I was thinner, or that I'd be healthier if I was thinner.

Of course even this article assumes that if you are hungrier because of exercise you will eat cake or donuts. I usually find that when I get done with exercise, what I want to pig out on is a pint of blueberries.

I guess that makes me a fatass glutton.

Funny how we don't want the government to run our lives, just the corporations

The very same people who scream about interventionist government are curiously silent when it comes to interventionist corporations:

In its effort to overhaul health care, Congress is planning to give employers sweeping new authority to reward employees for healthy behavior, including better diet, more exercise, weight loss and smoking cessation.

A web of federal rules limits what employers and insurers can do now.

Congress is seriously considering proposals to provide tax credits or other subsidies to employers who offer wellness programs that meet federal criteria. In addition, lawmakers said they would make it easier for employers to use financial rewards or penalties to promote healthy behavior among employees.

Two Democratic senators working on comprehensive health legislation, Max Baucus of Montana, the chairman of the Finance Committee, and Tom Harkin of Iowa, have taken the lead in devising such incentives.

“Prevention and wellness should be a centerpiece of health care reform,” said Mr. Harkin, who regularly climbs the stairs to his seventh-floor office on Capitol Hill.

The White House agrees. One of President Obama’s eight principles for health legislation is that it must “invest in prevention and wellness,” a goal espoused in almost identical words by Republican senators like John Cornyn of Texas and Orrin G. Hatch of Utah.

Frank B. McArdle, a health policy expert at Hewitt Associates, a benefits consulting firm, said, “Wellness and prevention programs have become a mainstream part of the benefits offered by large employers, and it’s virtually certain that Congress will include incentives for such programs” in its bill. The goals of such programs are to help people control blood pressure, fight obesity and manage diabetes and other chronic conditions.

Under Mr. Harkin’s proposal, employers could obtain tax credits for programs that offer periodic screenings for health problems and counseling to help employees adopt healthier lifestyles. Programs could focus on tobacco use, obesity, physical fitness, nutrition and depression, he said.

The idea of corporations operating in this country caring about "wellness" is preposterous. Isn't it funny how these programs address tobacco use, substance abuse, "blood pressure", and "obesity" (sic) -- while doing NOTHING WHATSOEVER about the stress of trying to keep up in today's corporation.

Don't get my wrong: I enjoy my job. I have a great boss, awesome co-workers, and the work is interesting. I am well-paid and have good benefits. I work for a company that seems to invest in its employees. I'm lucky that way. But those of you who are regular readers of this blog have probably realized I haven't been around much the last couple of weeks, and that's because I simply cannot seem to outrun my workload. That I have this workload is both a function of a sizable learning curve as I get up to speed not just on new processes, but about the science I need to understand to put my work in context. I could just slide by, but that's not my style. I realize also that additional projects I've been given are a compliment given to my employer's confidence in my capabilities. But that doesn't change the fact that I have spent most of the evenings and weekends over the past few weeks in front of a computer connected to a VPN, doing work. And I am not alone, particularly as this recession causes those of us who ARE working almost as much anxiety as among the unemployed, as we run ever-faster on our treadmills in an attempt to forestall our own crash-and-burn into the ranks of the unemployed.

I work with people in other countries all over the world. I have teleconferences that are often at 7 AM, but are sometimes at 2:30, or 4, or 5 in the morning. Last week I was at a conference out of town and found myself working late in my hotel room. I saw that some of my colleagues on the other side of the world were online, and was able to have an impromptu chat to resolve some project issues. It's fun, and it's interesting, and it's exciting, but the fact remains that I was having an online meeting at midnight on a weeknight. I was at a hotel that was a five-minute walk from the conference, so I could sleep till 7. But something like this at home, and I am dragging around like a zombie the next day.

It isn't just the time zones that make it difficult to get everyone together, because one thing I've found out is that once you get out of the U.S., you are dealing with workers who have one heck of a lot of vacation time and a lot of national holidays. I don't begrudge my colleagues their leisure time, but it simply points out the difference in the role of work life in other countries versis the role it has here. If we want to buy the line that Americans are truly "the most productive workers in the world", then this is why: because we are sacrificing everything else in our lives for work.

While employers are cutting jobs to appease Wall Street, the same or more work has to be done, and there are fewer workers to do it. I wonder why in all these efforts to foster "wellness" in the work force, no one is addressing workload stress.

A few years ago there was a rash of snake oil products promising to address what they said was the weight gain caused by excess secretions of cortisol -- an adrenal hormone that among other things, regulates blood pressure and insulin, as well as controlling the body's inflammatory response. Production of cortisol increases under stress, which can result in:

• Impaired cognitive performance
  
• Suppressed thyroid function
  
• Blood sugar imbalances such as hyperglycemia
  
• Decreased bone density
  
• Decrease in muscle tissue
  
• Higher blood pressure
  
• Lowered immunity and inflammatory responses in the body, slowed wound healing, and other health consequences
  
• Increased abdominal fat, which is associated with a greater amount of health problems than fat deposited in other areas of the body. Some of the health problems associated with increased stomach fat are heart attacks, strokes, the development of , higher levels of “bad” cholesterol (LDL) and lower levels of “good” cholesterol (HDL), which can lead to other health problems.

The products that talked about cortisol may have been snake oil, but isn't it interesting that no one is doing any research about the impact of cortisol on rising obesity and heart disease in this country. Even Dr. Howard Dean has gotten onto the "It's All Fast Food's Fault" bandwagon. Because if there were significant studies done that showed a definitive connection between stress and cortisol and weight gain, then perhaps something would have to be done about the work culture in this country, one which demands long hours that make it harder to find time to exercise, harder to find time to cook, that make a leisurely meal just about impossible. And we can't have that, now, can we, because then profits might fall short of Wall Street expectations.

So instead we have Congress offering corporate incentives that encourage corporations to implement carrot-and-stick approaches to "wellness" while not at all addressing the stress levels of American workers -- stress levels that have them chain-smoking when not at work, leaving the house at 6 AM and not getting home till 7 PM or later, ordering chicken parm subs from the local pizza place for lunch ans stopping at Boston Market on their way home because they didn't have time to stop at Whole Foods and buy the makings for quinoa, vegetable and seitan salad, let alone make the damn thing, and forgot to take out some chicken for dinner.

So what happens to employees who smoke, or who are overweight, or have high blood pressure during these employer-provided "screenings"? Are they first on the list when it comes time for layoffs, irrespective of their absentee records or the quality of their work? Are companies willing to provide not just on-site fitness programs but also time DURING THE WORKDAY for employees to use them? Discounts on gym memberships are useless if they mean I don't get home until 8:30 at night and have to go to bed at 9:30 if I'm going to be in on time the next day.

I've been battling my weight (and losing the battle) my entire life. Will employer-based programs actually work? My employer does Weight Watchers, a concept that sets my (and Kate Harding's) teeth on edge, with its weigh-ins and its lies about how "it's not a diet." Isn't it funny how Weight Watchers is a profitable multimillion dollar industry? How did it get that way if the program actually works? In the last few weeks the media have been all agog about how Kirstie Alley regained 83 pounds after her Jenny Craig contract expired. Kirstie Alley is 57 years old. She has been yo-yo dieting for years. Each time she gains more weight. Why isn't anyone looking at how this loss/gain cycle, repeated endlessly, causes us to be fatter? Why does a woman of 57 have to apologize for her weight? Remember Goldie Hawn as a young woman? She was stick-thin. She's stick-thin now. Of course she has to work harder at it now, but Goldie Hawn has never once for a day in her life had to worry that if she eats more than a lettuce leaf and tofu, she'll blow up like a balloon.

Now the Jenny Craig dream-seller is Valerie Bertinelli, whose airbrushed bikini-clad image is all over the place. She is 49. I suspect that her personal trainer and having the leisure time to go running five times a week (let's look at her knees in five years) had as much to do with her weight loss as Jenny Craig did. Let's see how long she keeps it off after she turns 50. Oh, right. She can afford a personal chef to make delicious, low-calorie meals every day.

A 2007 study found that at least 2/3 of dieters gain the weight back and more. In fact, dieting is a predictor of future weight gain. So why is the government encouraging employers to utilize such programs to foster "wellness"? Because it's easier to plop a Weight Watchers "counselor" into a meeting room once a week than to look at what American capitalism is doing to our health.

But let's not allow facts to interfere with our right as a society to loathe fat people

As hard as it was to be a fat kid when I was one, it's even worse today. After all, when I was a kid, Barbie may have been impossibly curvy, but at least she had a shape. And most of us didn't eat fast food, so they couldn't blame it on neglectful mothers feeding their kids McDonald's. In our family, we were chubby not because we gorged on sweets, but because we were from Russian and Polish peasant stock, our parents battled their weight, and because we were fed too much food, particularly meat. My father grew up during the Depression, and my mother was emotionally deprived when she was a child, so with their relationship with food not being all that healthy, we really didn't have much of a chance. Exercise and outdoor play wasn't exactly a priority either, and as a fearful and uncoordinated kid, school gym classes (which DCap, who is close to my age, outlined quite nicely earlier this week), I learned very early on that where sports and physical activity were concerned, "can't win, don't try. Add to my own situation being unusually short, and it was a perfect storm for lifelong weight issues.

As an adult, I've learned how to eat like a normal person, not that it's helped me with my weight issues. I went through my 'OMG I CAN EAT ALL THE ICE CREAM AND COOKIES I WANT NOW" phase when I moved out on my own, followed of course by the crash diet from which my metabolism never recovered, and finally ending up where they are now, with no white bread and yogurt and granola and lean meat and fish and no fried foods and no fast foods and lots of fruits and vegetables. But of course even though they keep finding biological reasons beyond "calories in, calories out" as to why some people are able to eat whatever they want and never gain a pound, the rest of us are expected to subsist on a lettuce leaf and the morning dew if that's what it takes to be thin.

I haven't had a blood draw in four years because I'm afraid to go to an internist who'll just tell me to go on a diet. Sorry, bub, been there, done that, and the last internist I went to was a size two, and that doesn't help either. But I cling to hope that someday children will be able to grow up and not be blamed for their own obesity.

I'd like to believe that time is now:

Exposure to chemicals used in plastics may be linked with childhood obesity, according to results from a long-term health study on girls who live in East Harlem and surrounding communities that were presented to community leaders on Thursday by researchers at Mount Sinai Medical Center.

The chemicals in question are called phthalates, which are used to to make plastics pliable and in personal care products. Phthalates, which are absorbed into the body, are a type of endocrine disruptor — chemicals that affect glands and hormones that regulate many bodily functions. They have raised concerns as possible carcinogens for more than a decade, but attention over their role in obesity is relatively recent.

The research linking endocrine disruptors with obesity has been growing recently. A number of animal studies have shown that exposing mice to some endocrine disruptors causes them be more obese. Chemicals that have raised concern include Bisphenol A (which is used in plastics) and perfluorooctanoic acid, which is often used to create nonstick surfaces.

However, the East Harlem study, which includes data published in the journal Epidemiology, presents some of the first evidence linking obesity and endocrine disruptors in humans.

The researchers measured exposure to phthalates by looking at the children’s urine. “The heaviest girls have the highest levels of phthalates metabolites in their urine,” said Dr. Philip J. Landrigan, a professor of pediatrics at Mount Sinai, one of the lead researchers on the study. “It goes up as the children get heavier, but it’s most evident in the heaviest kids.”

I'd like to believe that time is now, but it probably isn't. Watch for reports any day now from doctors who say that because some kids are more sensitive to phthalates than others, it just means that those kids who are will have to be careful all their lives about what they eat.

Because God forbid we should do anything about the packaging.

It's about damn time

I just wish that Kate Winslet, with an extraordinary body of work behind her already at the age of 33, didn't have to, as she quipped in that infamous episode of Extras, make a movie about the Holocaust -- a clip that will now live in infamy. It's true that to some degree, Winslet has played a variation of the same character in every film in which she's starred. She's always the free spirit battling the Forces of Authority and Expectation. But aren't most good roles for women some variation of this character? And if you have a choice between playing Woman Triumphant or, say, Sophie in Sophie's Choice or Leticia Musgrove in Monster's Ball, who are YOU going to want to play? The fact of the matter is that women who buck societal expectations are far more interesting as cinematic fodder.

When Winslet's body of work is discussed, it's always in the context of That Boat Movie and the films she's done since. But to get a sense of just how talented this woman is, you have to look back at the work she did before anyone knew who she was.

Here's Winslet at the age of seventeen in Heavenly Creatures, directed by a guy named Peter Jackson:

In Sense and Sensibility at eighteen:

And in Jude at nineteen:

And all this BEFORE the boat movie.

Say what you will, the woman has talent. She has talent, she's built her career the way SHE wanted it, not the way others might have; dieting down to a size zero and exercising her way into a column of sinew and gristle. She swears, she smokes, and doesn't mince words. And women everywhere adore her. But in the industry and the press, there's been this undercurrent of Katehate for the last decade, with endless articles about her weight, her personal life, and this year, her unabashed longing for the golden statue. Does the entertainment press really believe that any of these people believe that "it's an honor just to be nominated"? Do they really expect us to believe that disappointed losers don't spend a little time in the ladies' room fixing their mascara after a few unbidden tears crept out?

Perhaps it's that women aren't supposed to openly want anything. The obsession with Winslet's weight (and is there anyone left on earth who still thinks she's fat?), the fact that her characters are all women who WANT -- they want love, they want sex, they want to LIVE -- all contribute to the impression that this is a woman with APPETITES. And perhaps that's terrifying to an industry in which anything over a size zero is considered to be an elephant. And she WANTED to win an Academy Award, which seems to be some kind of heinous covetousness instead of refreshingly honest.

This is a woman who, like the characters she plays, lives her life on her own terms. Perhaps the entertainment press found her unseemingly covetous in recent weeks. But for those of us who admire the gift of being able to draw us into the inner life of a character on screen, last night was a recognition that is long overdue.

(UPDATE: God knows there's plenty about which I disagree with Melissa on a regular basis. But about this post? Word. But I think I like this photo better.)

And you thought only women had food issues

I'm not sure it's necessarily progress that men too now define their worth solely by what they eat:

Time to start reading Kate Harding, guys. Especially you, Maron.

Eat moderately. Enjoy what you eat. Take a walk. And what happens happens

Every year it happens, just like clockwork. The holidays are loaded with cookies and mashed potatoes with gravy and ham and chocolates and yams with brown sugar and marshmallows and parties -- and then after the caloric orgy come the New Year's resolutions, and nine times out of ten, these resolutions involve losing weight -- usually some ridiculous amount. Somehow I don't think it's different people making these resolutions every year; that there's an entirely new crop of fat people that pop up every year deciding to join Jenny Craig or Nutra-System or Weight Watchers, or order whatever the latest product is that's being hawked as recommended by Oprah (who is herself the poster child for Maybe You're Fighting The Wrong Battle).

If a drug doesn't show efficacy while undergoing studies, often the study is terminated the the drug under development scrapped. Any drug that shows as little efficacy in patient follow-up as diet plans do over the long-term would be scrapped. And yet every year, just like clockwork, the post-holiday amping up of weight loss plan advertising starts anew.

It isn't just about diets, either. This is the time when ads for fitness clubs and infomercials for exercise equipment ramp up as well. Funny how when we live in a society in which long hours are regarded as being synonymous with hard work and company loyalty at a time of diminishing jobs, and when schools are giving out "family homework" and commutes to work are getting longer, now it's no longer enough to go to Weight Watchers; you're now expected to add another two hours to an already hectic day to go to a gym and lift weights and walk on a treadmill.

And yet here is the most high-profile dieter in the country, Oprah Winfrey; a woman who is successful and beloved by many (even though I am not one of them), still defining her human worth solely through her weight, and right now she's regarding herself as worthless because despite having the resources to have a personal chef and a personal trainer, she STILL can't keep the weight off.

Maybe her body is trying to tell her something.

I read an article recently in which a woman who had lost a great deal of weight was still having trouble reaching her "goal weight", and so she was spending 3-4 hours a day at the gym. Do YOU have 3-4 hours a day to spend at the gym? I don't. And even if I did, that's not where I want to spend my time.

Now comes yet another study saying that unless you enjoy going to the gym, doing it just for weight loss is like running on a, well, treadmill -- you're not going to get very far:

Physical activity has many proven benefits.

It strengthens bones and muscles, improves mental health and mood, lowers blood pressure, improves cholesterol levels and reduces the risk of cardiovascular disease, diabetes, breast cancer and colon cancer. Exercise is also good for your brain.

It may not be a cure-all for obesity, however.

Though better nutrition coupled with exercise has long been the favored prescription for losing weight and avoiding obesity, a new study suggests diet actually plays the key role.

Researchers from Loyola University Health System and other centers compared African American women in metropolitan Chicago with women in rural Nigeria. On average, the Chicago women weighed 184 pounds and the Nigerian women weighed 127 pounds.

Researchers had expected to find that the slimmer Nigerian women would be more physically active. To their surprise, they found no significant difference between the two groups in the amount of calories burned during physical activity.

"Decreased physical activity may not be the primary driver of the obesity epidemic," said Loyola nutritionist Amy Luke, a member of the study team.

I'm not saying that exercise is a bad thing. God knows I feel better when I take a half-hour walk at lunchtime now that I no longer have time before leaving for work in the morning. But the notion that obese people are REQUIRED to do endless hours in the gym in order to fight a battle they can't win ought to be debunked.

Of course this won't do it, not in a world in which Kate Harding gets trolls like the one described here. And not in a world in which women are judged solely based on the amount of space we take up. Sure, the doctors (like rail-thin Barack Obama's choice for surgeon general, Sanjay Gupta) talk about obesity and health, but when there's a study like this one, which obliquely points to the possibility that SOME obesity may be due not to "laziness" or consumption of fast food, but something in the foods that are widely available in this country that is at least contributing to increased levels of obesity. Or to the extent that physical activity is a factor, activity that's related to actually doing something, such as housework or yard work or playing a friendly game of tennis or softball, or taking a walk through the woods and enjoying the sounds and smells of nature may have a greater effect than grimly plodding along on a treadmill while looking out of the gym windows at a beautiful sunny day.

You'd think that after all the research, we would have reached a conclusion that there is no magic bullet for being thin. Yes, there are people who have spent their lives struggling with weight who, by devoting their entire waking, nonworking lives to the pursuit of thinness, have managed to fight their bodies' tendency to store fat. But does that mean that everyone should have this as a singular focus? Should fat people be doomed to denying themselves the pleasure of a social evening with friends because it might involve food? Should fat people have to isolate themselves in a cocoon of iPod-fed music, spending every waking hour at the gym when others can get by with a good brisk walk for an hour? Should fat people have to regard a restaurant menu as an enemy while their thin compatriots can feel free to order the fetuccine alfredo if that's what they're really wanting that day?

We're exposed every day, especially online, to the latest "magic bullet" for weight loss. Açai berries. Hoodia. Celebrity physicians put their name to this stuff. And yet, despite this, and all the diet plans and the gyms offering $20/month memberships, people are still fighting this battle. We're in a kind of Iraq War with our bodies in this country and thinking like John McCain -- that if we just pour enough money and resources into this battle, we can win it; even if we don't know what that victory looks like other than that it fits into a certain pair of jeans. We're not thinking about the cost to our social or even physical well-being.

This article on "The 11 Best Foods You Aren't Eating" from the New York Times web site got me thinking, because I AM eating many of these foods. I love Swiss chard, especially the red kind. Blueberries are my favorite fruit. I put cinnamon in my coffee every morning because I like the flavor and smoothness it gives coffee, and if it helps my LDL, so much the better. Garlic. Olive oil. Whole-grain bread. Lean meat and fish. Fresh fruit. Broccoli. Brussels sprouts, when tossed with a little olive oil, balsamic vinegar, and garlic, then roasted for 20 minutes in a 400 degree oven, is the most heavenly vegetable on the face of the earth. All yummy, all things I like. Last time I tried to eat a Wendy's hamburger, I said "Yuck....this tastes NASTY." I don't have time to take a long 45-50 minute walk in the morning anymore, but I do have time in the middle of the day to take a half-hour brisk walk of three loops around the parking lot with a friend. And I am still what the TV doctors would call obese. And so are many others with perfectly "healthy" eating habits who DON'T frequent fast food joints.

Funny how they never want to study people like me. After all, why should they? There's a multibillion dollar industry at stake, one which relies on being stocked with fresh souls every January.

Thursday Big Blue Smurf Blogging: What They Said

Today's honoree: Kate Harding, for her sound advice to Oprah Winfrey.

Money quote:

I could sit here and tell you how I went on Lexapro, and I started eating out more and resumed putting the dressing directly on my salads and slacked somewhat on exercise — in a nutshell, how I gave up dieting as a part-time job and relegated food and exercise back to the category of ”things I think about, just not to the exclusion of having a life” — but the real reason for the weight gain is, I’m just not that special. I do not have magic powers that allow me to transcend my genetic predisposition to fatness, and I was not so much more committed or determined or desirous of thinness than everyone else who diets that I could somehow, through sheer will, overcome the massive odds against keeping it off for more than five years. I’m just not that special.

Neither are you, in that regard. We’re both plenty special in other ways — I mean, love you or hate you, I don’t think there’s anyone who would argue that you’re not an extraordinary woman — but just not that way. In that way, we’re both just normal fat women who dieted and gained it back and dieted and gained it back and dieted and gained it back, as normal fat women do. But here’s the difference between you and me, when it comes to that. You hit 200 and sent out a press release detailing your shame, embarrassment, and anger at yourself. I hit 200 and shrugged. Because it’s not any different than being 199, and not really any different from being 185, and when it comes down to it, not all that much different than being 115. I can’t shop at as many stores, I don’t get hit on quite as often (though I still do, as recently as Sunday night), some people aren’t as friendly to me, and some people are downright hateful in ways they wouldn’t have been when I was thin. But as trite as it may sound, this is the damned truth: I’m still the same person I was when I was thin — and when I was in-between, and the day before I cracked 200, and the day after.