By Liz Massey, April 9, 2015.
For more than 75 years, one of the major premises driving physical self-improvement regimens has been that being fat is bad for one’s health. In 2010, First Lady Michelle Obama unveiled her “Let’s Move” campaign, designed to eliminate childhood obesity in one generation. The Affordable Care Act, signed into law that same year, boosted existing incentives in the medical community to make reducing obesity among Americans a higher priority.
Just five years later, a growing body of research is calling into question the presumption that weighing over a certain amount designated as “normal” is in and of itself harmful to one’s health.
THE CASE AGAINST DIETING
As counterintuitive as it may seem, there is quite a bit of scientific data indicating that calorie restriction as a means of weight reduction – that is, going on a diet – is rarely successful in the long term. Researchers Priya Sumithran and Joseph Proietto, co-authors of a 2013 article in the journal Clinical Science, explained the physiological dynamic this way:
“Although weight loss can usually be achieved through dietary restriction and/or increased physical activity, the overwhelming majority of people regain the weight that they have lost over the long-term ... Diet-induced weight loss is accompanied by several physiological changes which encourage weight regain, including alterations in energy expenditure, substrate metabolism and hormone pathways involved in appetite regulation, many of which persist beyond the initial weight loss period.”
Nutrition professor and researcher Linda Bacon, the author of the books Health At Every Size and Body Respect, asserts that the link between obesity and ill-health is less established than the anti-obesity forces have made it seem.
“The relationship between body size and health is very much exaggerated,” Bacon said. “Despite what we hear from the media and ‘experts,’ there are plenty of larger people living happy, healthy lives – and plenty of thinner people diagnosed with conditions that are conventionally attributed to obesity.”
QUEERING THE SCALES
Another factor related to obesity in LGBT people that’s frequently overlooked is the health consequences of oppression. According to globalhealth.gov, a website produced by the U.S. Department of Health and Human Services’ Office of Global Affairs, throughout the world lesbian, gay, bisexual and transgender individuals face poorer health outcomes than the general population. The site identifies denial of care, substandard care and, in some cases, an unwillingness on the part of queer people to go to a doctor because of discrimination as major factors in producing the poorer health outcomes.
Bacon, who identifies as queer in her sexual orientation and genderqueer in her gender identity, takes the link between anti-LGBT oppression and disease a step further, asserting that the stigma that LGBT people face in their daily lives is a factor in poor health that’s far more significant than the community’s higher-than-average rates of obesity.
“Data show that chronic stress exacerbates metabolic dysregulation, contributing to many of the diseases we blame on obesity,” she said. “Chronic stress arises from all forms of stigma, oppression and discrimination, including homophobia … The social gradient in disease can’t be primarily explained by weight, genetics or lifestyle alone and has its roots in inequalities in life opportunities and experiences.”
PERSUING HEALTH AT EVERY SIZE
Bacon’s alternative to dieting and exercise as a vehicle to lose weight is a system that emphasizes healthy living as an end in itself. Participants in her Health At Every Size (HAES) programs are encouraged to listen to their body’s signals related to hunger and fullness, and to find pleasurable ways to move their body on a frequent basis.
There is already some evidence that programs structured in ways similar to HAES are effective. A study published in the November 2009 issue of the Journal of the American Dietetic Association found that found that food intake in response to feelings of hunger was significantly lower at a one-year follow-up in both a HAES-style health focused group and a weight-loss-focused social support group, when compared to a control group receiving no intervention. In addition, overconsumption of food in response to a variety of stimuli was significantly lower at the one-year mark in the HAES group than in the control group.
A separate study published last year in the Academy of Nutrition and Dietetics indicated that health interventions that do not focus on dieting had completion rates as high as 92 percent – meaning that the participants were able to stay with the program and continued to experience physical and mental benefits from doing so.
SELF-LOVE AS THE ROAD TO HEALTH
“The most basic step I’d recommend is to put the focus on enjoying and appreciating your body,” she said. “ I look at my legs, for example, and I think about how amazing it is that they help me get from one place to another … People take good care of things they like. There’s plenty of research that shows that self-care, like eating well and exercising regularly, improves when people start from self-acceptance, rather than self-criticism.”
Beyond renegotiating one’s relationships with food and exercise, LGBT equality activism might well be considered another path to body acceptance. Bacon said that being able to celebrate one’s sexuality and gender identity was an important part of healing one’s relationship with self-care behaviors.
“There are clear connections between all social justice struggles,” Bacon said. “Ultimately, we’re all looking for the same thing: the right to inhabit our bodies with respect.”
Seeking The Bear Necessities Of Life – And Health
While the effectiveness of dieting has come under increased scrutiny in recent years, groups within the LGBT community that have always practiced body acceptance say this has helped them create an inclusive niche that buffers the stress of being stigmatized by a oftentimes hostile mainstream society.
According to Dennis Veneigh Jr., vice president of the Bears of the Old Pueblo group in Tucson, while bears he knows these days focus more on the amount of body hair than on physique, the bear community is definitely a place where thin is not a requirement for seeming desirable.
“In the bear community, we are all very comfortable in our body image and size. We are all very friendly, supportive and outgoing with each other,” he said.
Veneigh said that his friends in the Bears of the Old Pueblo group vary in their approach to diet and exercise. In his case, a struggle with his weight eventually led him to discuss weight-loss surgery with his doctor. Last year, he decided to undergo a procedure called Vertical Sleeve Gastrectomy to deal with his weight, which at one point topped the scales at 384 pounds. He says he has lost a total of 125 pounds in nine months and is aiming for a goal weight of 190 to 210 pounds.
Overall, Veneigh said he feels the queer community is open-minded about body shape and appearance, although there were definitely exceptions.
“I feel that some LGBT folks are very accepting (of various body sizes), but not all communities are,” he said. “Some still look down on the bear or chub (large-man) communities.”
That inside-the-community stigma seemed especially sad to Veneigh, who said that the acceptance he experienced within the bear community also offered protection against the hostility that he and other gay people can experience from conservative quarters of the cultural mainstream.
“We just need to support each other in our life choices and struggles,” he said. “We are all brothers.”
