Show notes
Hello and welcome to another audio version of Burnt Toast!This is a newsletter where we explore questions (and some answers) around fatphobia, diet culture, parenting, and health. I’m Virginia Sole-Smith, a journalist who covers weight stigma and diet culture, and the author of The Eating Instinct and the forthcoming Fat Kid Phobia. Today, we’re going to do another solo episode where I answer your questions.But first! I’m curious to know what folks think about the guest episodes versus the solo episodes. Right now I’m doing like one solo a month, and then three guest ones. Maybe you would like a different balance of guests to solo? I’m also always curious to know how many folks download and listen or how many listen to the audio versus read the transcript. I’m happy to keep doing both—I think they’re both really useful—but you know, I’m just interested. So if you have any thoughts about that, please comment on this post. That is a long way of saying any feedback is always very welcome.Let’s dive into questions! Sometimes I manage to group these with a theme and this week, I don’t think there is a theme. It’s just kind of a grab bag. I mean, there’s the obvious themes of diet culture and fat phobia, but I don’t think I have a narrower theme than that. But that’s okay! There’s a lot of really interesting stuff in your questions this week.Q: I loved your book and I’m just starting to try to disentangle myself from my own diet and body image hang-ups, most of which were absorbed through my loving, amazing, subtle fat-shaming family. Occasionally we engage in discussions over weight and health and while I can bust out all the stats and research I can about health and weight they inevitably bring up their ace in the hole to win the argument every time: Namely, there aren’t many obese/fat old people. And I can’t counter it because I’ve seen it myself every time I visit a relative in a long-term care home; everyone there is very old, and very thin. Any thoughts/research on this? If weight doesn’t automatically equal unhealthy outcomes, where are all the old fat people at?A: This is such an interesting question: Where have all the old fat people gone?What I think is happening here, is confirmation bias. I think we are confusing what we see in our own lives and our own bubbles with, this must be true for everyone. And this happens all the time in conversations around weight and health. Think of every Thin Man in your life who, even if they do gain weight, sort of effortlessly loses it just by starting to run once a week or something. And then they think everybody could lose weight so easily if they just did this. That’s confirmation bias. That’s thinking that your own lived experience is representative of everybody’s lived experience. And we know it’s not. But this comes up a lot.But this is definitely a new twist on it, this idea that just because fat old people are invisible to you, they must not exist.I will link to Katherine Flegal’s research on this. We know that folks in the “overweight” and “low ob*se” BMI ranges have the longest mortality. So we know that those folks are living longer than people in the “normal weight” or “underweight” ranges. At the extreme ends of the spectrum, the data is a little less clear. Folks in the very highest-weight bodies may have more complicated health issues, just like the folks at the most underweight level. And in both cases, this may impact longevity. But in the sort of skinny to small fat/medium fat space, we’re seeing that bigger bodies live longer.So why aren’t you seeing them in the nursing home that you visit? Maybe because the nursing home you visit caters to a demographic that doesn’t have higher rates of larger body sizes. If you’re in an affluent, mostly white community, you may not see bigger body sizes as often in general, and certainly not in the nursing home setting.Also: If Flegal’s research suggests that higher body weight is protective in aging, then those folks might not be in long term care facilities. Fat old folks might be able to live independently at home longer. And so you don’t see them in the nursing homes that you’re going to, you’re seeing there the frailest and sickest people, perhaps, and those might not be the people in the larger bodies. So this is just playing with this assumption that you’re having—I’m not saying this is definitively what’s happening in the nursing home that you visit. Of course, as much as we know that larger body size is linked with longer mortality, we don’t know that that’s a causal relationship. It’s a correlation. So we don’t know that body weight really has much of anything to do with how long you live. You may be seeing smaller bodies in this nursing home, but that is not reflective of the general aging experience. Or these people may have been in bigger bodies earlier in their lives that enabled them to live longer. As we reach our later years, the elderly and the geriatric population does tend to lose both body fat and muscle mass with aging. So people are again frailer and also thinner once they are very old. That doesn’t mean they were that thin their entire life, that just means that’s the body you’re seeing them in right now.So yes, you’re seeing this. But you’re not seeing the entire experience. One nursing home is not representative of even your entire community, let alone your state, your region, your country. There could be good reasons that you’re not seeing bigger bodies there. There could be bad reasons. It could be that folks in bigger bodies receive worse health care. So even if we’re seeing some protective benefits of larger bodies, we may also see that folks receive worse health care, have less access to health care, and maybe they are less likely to access the type of long term care facility you’re talking about. So there is a lot of nuance there. But I do think that “I don’t see old fat people” is not proof that they don’t exist. They are out there. Hopefully that gives you some nuggets to take back to your family conversations.Q:Do you think intentional weight loss (and/or intentional weight change, including gaining weight) is always bad? Do you think there is any room for folks to intentionally change this aspect of their bodies just like we might change any number of other physical and aesthetic characteristics? Is there any way of decoupling intentional weight change from diet culture? (That last part is my biggest concern, of course.)I think what this person is asking—well, they may not be asking it, but what I am often asked under the guise of this question is: Can I be anti-diet and still be dieting?You can absolutely fight weight stigma, you can think that fatphobia is wrong, you can call it out, you can parent in ways that are weight-inclusive, you can support weight-inclusive health care, you can do all of that… and still not love the body you’re in. Our individual body struggles are quite separate from this as a sort of political social justice movement, so I think that is worth acknowledging and saying pretty explicitly. I think most people who do this work have our own stories of dieting and body acceptance struggles, and so relate very much to the idea that personally, you may not be where you want to be politically or publicly.But do I think that personal struggle can happen separately from diet culture? At this stage? I do not.Anytime we pursue intentional weight loss and try to change ourselves in an aesthetic way, we are driven, at least in part, by the central diet culture message that we should take up less space. It’s just the water we’re swimming in. It’s the social conditioning we have received since we were children. It is incredibly hard to turn off that noise and say, no, I definitely would want this in a void, I would want to be thinner for X, Y, and Z reasons, even if diet culture didn’t exist, and thinness gave me no social currency, and didn’t make it easier to buy clothes, and didn’t make my body feel more acceptable to society. I don’t think you can even really run that thought experiment because we cannot silence that noise. So, do I think intentional weight loss is always bad? I’m not going to shame behaviors because hey, who does that—diet culture, right? If you are dieting or intentionally losing weight, because that is something you feel you need, I am not here to judge your personal struggle. I think this is especially important to say when we’re talking about folks who live in fat bodies and decide to pursue bariatric weight loss surgery. If you have not lived in a larger body, and faced that pressure and faced the daily onslaught of weight stigma and the difficulties in accessing health care, and the reasons why that surgery might feel necessary, you are not in any position to judge that person’s decision to pursue intentional weight loss.At the same time, I think I always feel a little bit sad, because it’s a reminder that our world could be so much better. And it’s not. We are not making the world a safe place for fat people. We’re really not making the world a safe place for anyone with a body, but particularly not for fat people. So anytime I hear about someone intentionally pursuing weight loss, I’m just reminded of how much work we have to do. Because yes, if we could get to a point where weight loss was something you could manipulate as easily as, say, dying your hair, then maybe you could say that this is a temporary aesthetic change, and you’re making it for fun and self expression. [Virginia’s post-recording note: Something I forgot to add here is that even if it was truly harmless to the individual, weight loss would still be a way of reinforcing the idea that thin bodies are more valuable than fat ones—which they aren’t. The anti-fat bias is impossible to escape.]But even hair dying is not a great example of that, right, because often women dye our hair to cover our grays, to look younger, because we live in an ageist society. So pretty much any aesthetic change we make has some component of cultural pressure and cultural conditioning attached to it. And it doesn’t mean you should completely stop making any of these changes. I dye my hair, you know, and we all wear clothes, and people wear contact lenses, etc, etc. And it can certainly be a part of personal expression, and feeling good about your body and also be a response to these cultural messages.But the reason to put weight loss, intentional weight loss, in a separate category from say, hair dye, is because intentional weight loss can be really dangerous physically. It can lead to a disordered relationship with food and your body. It can cause spiraling and anxiety and ruminating and compulsive thoughts and compulsive behaviors in a way that making choices about shoes or hair doesn’t because these other more easily changeable choices don’t have quite the same impact on our physical health, or our mental health. And again, I’m speaking broadly here—there’s going to be someone who comments and says, no, actually dyeing my hair is like this hugely complicated, dramatic journey for me, and I want to hold space for you in that journey. But we don’t have an epidemic of hair disorders, and we do have an epidemic of eating disorders. I resist saying it’s always bad, because that sounds like I’m saying the person pursuing the weight loss is bad, and I’m not. But I do think intentional weight loss is never simple. I think it’s never just about health, or just about, oh, I don’t like how my pants fit, but I’m fine with other people being in bigger bodies. I think we find lots of ways to rationalize the desire for intentional weight loss to ourselves. And I did this for years. I wanted to support Health at Every Size, and I was dieting myself. So I really relate to this place that this questioner is in, wanting to say, I’m doing this for me, but that’s separate from the larger struggle. The truth is, we’re always intertwined with our personal and our political. With something like intentional weight loss, where the side effects can be so serious and so severe, I think it is especially important to approach that with caution.If weight loss is something you’re pursuing because you’ve been told it’s necessary for your health, I would encourage you to check out the HAES Health Sheets that were created by Louise Metz and Ragen Chastain. They are a phenomenal resource for thinking about weight-linked conditions, from a weight-inclusive perspective. That might give you some other options to think about, do I really need to pursue weight loss for my health? Or is there another way to treat my high blood pressure? Or my acid reflux?And if it’s about aesthetics, well, then I think you already know the answer that that’s a diet culture-driven thing. The thin ideal is driven by diet culture, it’s driven by white supremacy, it’s driven by patriarchy. It is uncomfortable to acknowledge that we are all complicit in it, but there it is. So yeah, I think we’re a long way from being able to decouple this and I’m also not sure that that should be the goal, because if we say we’ve decoupled unintentional weight loss from all of these toxic narratives, and it’s totally fine to pursue it, you’re still saying fundamentally, that smaller bodies are better, you’re still saying that this whole group of people who live in larger bodies, for whom intentional weight loss is not an option or would never achieve a thinner, a truly thinner body, that their bodies are somehow less than. So yeah, I don’t see it untangling anytime soon.Okay, next question. The TL/DR version of this question is: My daughter “binges” on food and I don’t know how much I should control this.Q:My 10-year-old daughter hit puberty young and has a larger body. She has not displayed any body dissatisfaction, or said anything negative about her body in front of me. She is very active and she loves food. Food is what motivates her. Food is what she turns to in boredom. She gets a lot of pleasure from food. I don’t see any of that as a problem. My concern (and my husband’s concern, who doesn’t handle it the way I would like) is that with being home all the time the last 1.5 years and counting, she is eating all day. She eats 3 “meals” in a row, each time saying she is still hungry. I try to advise her to wait a little while between meals so her body has time to realize she already ate, but she won’t do that. She’s also cooking and preparing her own food, which I love and think it is wonderful that she is independent in this area. I’m just not sure if she is ready to have all limits off on quantity of food. This might look like a tortilla with eggs and bacon, followed by frozen tamales, followed by melted cheese and crackers. She never chooses fruits or veg. If there is any sort of candy, ice cream, or baked good, she will eat it all right away and not choose any other food until that is gone. Part of the reason this is triggering for me is that I am a binge eater and it looks like she is binging when she loads up on food like this and when she is hyper-focused on the sweet foods.A: I think there’s a lot going on here. I want to be clear that I am not a therapist or a dietician or a healthcare provider trained to diagnose or treat eating disorders, and also a podcast would not be the setting to do that even if I was. So I encourage you to reach out to a therapist who approaches weight and family feeding dynamics from a weight inclusive Health at Every Size perspective. I like Christy Harrison’s list of providers so linking that here. And I’m saying that, not because I think your daughter is showing so many red flags of a huge eating disorder, but because you are really struggling with her eating, and I think you deserve support and help to navigate what this is bringing up for you so that you can best support your daughter.Now, as a lay person who reports on this a lot and who hears a lot of people’s eating stories, a lot of what you’re describing sou…
Full show notes at the publisher