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By Samantha Thomas, August 14, 2011

This week our paper on the Fatosphere was published!!! I know many of you who read this blog took part in the study and the results are now out.

So what was the study about? For a long time now I have been curious about the misconceptions about, and attacks on the Fat Acceptance movement. So about 18 months ago, my terrific PhD student Marissa Dickins embarked on trying to find out what the Fatosphere was really about. In particular we were curious about how Fat Acceptance bloggers used the Fatosphere to proactively respond to fat stigma.

In dominant obesity discourses, there is a clear assumption that if we can just get people to lose weight, then fat stigma will disappear. Rather than challenging the stigma, we expect fat people to conform to a medical and aesthetic norm of thinness. Some recent papers have even suggested that once fat people lose significant amounts of weight, that they themselves realize they are at fault for causing the stigma.

My take on this is that the undesirability of being fat, and the moral assumptions that come along with that, cause many obese adults to internalise weight based stigma. And because of this they spend significant amounts of time dieting and exercising their socks of trying to overcome that stigma. For many adults this pattern becomes more and more severe, the more the attempts fail.

So what happens when individuals start to say a big FU to this pathway and start to reframe the way they think about health and wellbeing? What happens when you take the focus off weight loss, and start to fight the stigma?

This is what we explored in our study.

We found that the journey to the Fatosphere is not an easy one for most people. People don’t suddenly wake up and think: ‘Hey, today I’m going to totally go against everything I’ve been told my whole life about how bad I am because I’m fat. And I’m going to say screw you to that dominant ideal. I’m going to start taking care of myself.’

Rather, the journey to self acceptance was a long one. In the paper we use a model to show the different stages that people go through in coming into the Fat Acceptance community.

Perhaps most importantly was what happened when people started interacting with the Fat Acceptance movement. For me one of the most interesting things was the extent to which the Fatosphere allowed people a ‘voice’ to counter stigma. That it empowered people to share experiences, and challenge dominant views about fatness. In many instances, it provided a safe space, a place to celebrate, share, embrace, and most importantly support – without a pressure to be on a journey to thinness. It also made me realise how absent those spaces are in the offline world.

And with this in mind, we found that the Fatosphere was also health promoting. Participants in the study described their mental and emotional health improving, and that they started taking part in activity because they enjoyed it rather than doing it just because it was part of a weight loss regime.

We can’t make any conclusions from this paper about whether Fat Acceptance is good for everyone. But I think the research  shows that this is a powerful model for people to respond to and feel supported with the constant stigma that they face in society.

A massive thank you to everyone who took part in the study. And to Bri King who is also an author on the paper and gave us such great help in contacting everyone and thinking things through.

We are now working on other papers from the study. There was a huge amount of data, so we look forward to sharing more with you in the coming months.

If you would like a copy of the paper, please don’t hesitate to ask

Dickins M, Thomas SL, King B, Lewis S, Holland K. The Role of the Fatosphere in Fat Adults’ Responses to Obesity Stigma: A Model of Empowerment Without a Focus on Weight Loss. Qual Health Res. 2011 Aug 2. [Epub ahead of print]

Obese adults face pervasive and repeated weight-based stigma. Few researchers have explored how obese individuals proactively respond to stigma outside of a dominant weight-loss framework. Using a grounded theory approach, we explored the experiences of 44 bloggers within the Fatosphere-an online fat-acceptance community. We investigated participants’ pathways into the Fatosphere, how they responded to and interacted with stigma, and how they described the impact of fat acceptance on their health and well-being. The concepts and support associated with the fat-acceptance movement helped participants shift from reactive strategies in responding to stigma (conforming to dominant discourses through weight loss) to proactive responses to resist stigma (reframing “fat” and self-acceptance). Participants perceived that blogging within the Fatosphere led them to feel more empowered. Participants also described the benefits of belonging to a supportive community, and improvements in their health and well-being. The Fatosphere provides an alternative pathway for obese individuals to counter and cope with weight-based stigma.

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By Samantha Thomas, July 19, 2011

It’s easy to get caught up in the hype and to forget the facts.

And it is especially easy when we get given the wrong information about an issue repeatedly.

Over the last week here in Oz we have had some pretty interesting reports about the escalating rates of childhood obesity in Australia and what to do about it.

The problem is – that we don’t have massively increasing rates of obesity in Australia. In fact, over the last decade rates of obesity in kids has plateaued in Australia.

Of course there are obese children in Australia. But the ‘epidemic’ we keep hearing about doesn’t really seem to be getting any worse.

Here are a couple of really good quality Australian studies which show that obesity rates have levelled off, or decreased in some groups.

Olds, T. S. et al Trends in the prevalence of childhood overweight and obesity in Australia between 1985 and 2008 International Journal of Obesity (2010) 34, 57–66;

Results: There has been a plateau, or only slight increase, in the percentage of boys and girls classified as overweight or obese, with almost no change over the last 10 years. In boys and girls, prevalence rates have settled around 21–25% for overweight and obesity together, and 5–6% for obesity alone. Similar trends were found for BMI z-scores. These patterns were fairly consistent across the age span. Within each weight-status category, average BMI has not increased. Conclusions: Although levels of Australian paediatric overweight remain high, the prevalence of overweight andobesityseems to have flattened and has not followed the anticipated exponential trajectory.

Nichols MS, de Silva-Sanigorski AM, Cleary JE, Goldfeld SR, Colahan A and Swinburn BA. Decreasing trends in overweight and obesity among an Australian population of preschool children. Int J Obes (Lond) 2011;online March 22

Results: Complete data were available for 129 266 2-year-old children and 96 164 3.5-year-old children from 41 local government areas across Victoria. Combined prevalence of overweight and obesity decreased significantly between 1999 and 2007 in 3.5-year-old children (by 3.1% points from 18.5 to 15.4%) and in 2-year-old children (1.1% point decrease from 13.5 to 12.4%). There was no accompanying increase in rates of underweight. Decreases were more pronounced in areas of lower socioeconomic status (SES). Prevalence of both overweight and obesity was consistently higher across time in the older group of children, in the lowest quartile of SES and among girls. Conclusions: Prevalence of overweight and obesity in preschool children in Victoria has decreased significantly between 1999 and 2007, whereas socioeconomic disparities have narrowed.

So bookmark this page, and next time you see people talking about the rates of childhood obesity in Oz, you can refer them back here.

Comments (32)

By Samantha Thomas, July 15, 2011

Everyone has an opinion about fat. I get that. Fatness pushes buttons for people – probably because we have all had a fear of fatness (and fatties) drummed into us from an early age.

And now with the medicalisation of fat, and the hysteria associated with the obesity epidemic, everyone feels entitled to have an opinion about fatness.

I get that too. Kinda.

What I don’t get is how everyone thinks that they are an expert on this issue.

That they can spout all sorts of uninformed nonsense about obesity, its causes and solutions, and remain absolutely steadfast in those beliefs – no matter how much they are called on their bullshit.

Yesterday, a morning breakfast show ran a very short segment on a JAMA article that recommended that state intervention could be used in ‘life threatening childhood obesity’.  I highlight that term in particular, because that seemed to get changed to ‘all fat kids’ as the day progressed and the Twitterati started to add in their two cents on the issue. I will come back to that in a minute.

They had a parenting expert on who, is a very nice person, but was not well equipped to answer the complex range of issues that this story raised.  The segment did not address the key points of the article in detail (and that’s fine, it’s Breakfast TV after all!!) but also some of the complex medical issues that might cause ‘life threatening childhood obesity’. Now, while I don’t expect brekkie TV to go into great detail, I do think they should highlight the main points of the argument. I would have hoped that everyone (particularly those commenting) would have read the JAMA article – or at least have the gist of it – before launching into commentary about it.

Let me give you a snapshot of what the authors of the JAMA article said so that we can have a proper robust debate about this. As a researcher, I feel like I should give you some facts about what the authors said (whether I agree with them or not):

1) The children that are being discussed in this article are those in the 99th weight percentile – categorised as severely obese (again remember I’m just here to give you the facts of the article!)

2) The authors state that the health issues associated with children in the weight range are generally related to extremely disordered eating (ie an eating disorder), and they are concerned with the health consequences of that, in particular they raise the issue of Type II Diabetes.

3) They raise concern about the number of these children who are being referred for, and having bariatric surgery, stating:

“However, the long-term safety and effectiveness of this invasive procedure in adolescents remains unknown, and serious perioperative and long-term morbidity and mortality have been reported. As an alternative therapeutic approach, placement of the severely obese child under protective custody warrants discussion.”

The authors then go on to discuss some of the various legal implications of the removing obese children and conclude that :

“Indeed, it may be unethical to subject such children to an invasive and irreversible procedure [obesity surgery] without first considering foster care. Nevertheless, state intervention would clearly not be desirable or practical, and probably not be legally justifiable…..Moreover, the quality of foster care varies greatly; removal from the home does not guarantee improved physical health, and substantial psychosocial morbidity may ensue.”

They conclude that more investment is needed in social infrastructure.

But unfortunately these things weren’t mentioned really on the telly segment. Rather we got the old, ‘you can encourage people to eat less and exercise more’, that we needed ‘education education education’ for parents, and that schools had a role to play in teaching kids about weight and nutrition.

That is problematic. Because it places all the responsibility back on the individual to change, rather than addressing the structural and inequality issues that mean that some people may not be able to make the choices that others can.  Education means stuff all when you are struggling to put a meal – ANY MEAL – on the table at night.

It also assumes that we can all be thin – if we just have enough education and if we try hard enough.

So here is how this paper got picked up and translated by people on Twitter yesterday:

“I think it’s a cultural laziness. Parents won’t say no, nor encourage activity through good example because it’s hard work.”

“Many parents are too lazy to say no or to cook a meal”

“EVERYONE is judged daily”

“Part of parenting should include us being able to teach our kids about nutrition and exercise”

And then there were more people advocating for education, counselling, blah de blah…

SAVE THE FAT PEOPLE FROM THEMSELVES AND FROM KILLING THEIR CHILDREN. EDUCATE THEM. COUNSEL THEM. TELL THEM TO TAKE SOME RESPONSIBILITY.

*Deep Breath*

Here’s the thing. The parents of fat children love their kids no more or less than any other person in the community. And I personally don’t think they are lazier or less responsible as parents than any other group.

But they sure are treated by some people in the community as though they are.

I don’t agree with the removal of kids from their parents because of their ‘severe obesity’. And I definitely do not think that bariatric surgery is a good option for kids either. But my reading of the JAMA paper is that the authors don’t think they are good options either. Maybe this paper is more about how horrific it is that we are systematically putting children through surgical options with no real understanding of their long term consequences.

Severe obesity in children is not child abuse. It is the result of a very complex range of issues. And ‘solving’ some of those issues (if there even are solutions) will not necessarily make a child thin(ner).

However, I firmly believe that tackling the stigma associated with the way we respond to and think about these issues can only help to improve the health of individuals – no matter what their size.

Placing responsibility at the feet of parents and the child just reinforces the stigma.

Ref: JAMA. 2011;306(2):206-207. doi:10.1001/jama.2011.903

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By Samantha Thomas, July 11, 2011

Have you ever had one of those days when you are just so freaking busy you feel like your brain is going to burst?  Like you literally feel like it is going to explode out of your head. That there are so many thoughts competing with each other that you can’t seem to make sense of anything at all. When everyone seems to need you all at the same time for completely different things – urgently.

And the thought that seems to keep rising to the surface is the one that is telling you that you need to just crawl into bed and sleep – uninterrupted for at least a day (or two).

Last year some supposedly smart Professors found that women are far better at multitasking than men. They discovered this by getting men and women to do a series of tasks over an eight minute period, and concluded that women were far more capable at doing the tasks than the blokes.

Conclusion: Women can do it all… at once. (No mention of the ‘for 8 minutes’ part of the equation)

Well, I’m calling bullshit on that. Because we can’t. And we shouldn’t have to. And we shouldn’t be expected to.

I have two little kids. They are awesome. But they need me. Sometimes in the middle of the night. Sometimes in the day. Sometimes all day.

I also work full time. And there are demands with that job. Mostly great. Some not so great. But demands nevertheless. Sometimes those demands are relentless.

I took a day annual leave last week to spend with my little boy on school holidays and there wasn’t an hour when my phone didn’t ring or the email didn’t ping. And even when I explained I was on leave there was still the “oh I’m so sorry… can I just ask you quickly for x y z” “can you just send me that” “are you okay with this”.  And although you feel like saying “GO AWAY”, you still answer the question or provide what is needed.  You still answer the phone, or return the email.

I don’t know why? Maybe as women we feel like we need to do it all, that we should be able to cope, that it is expected of us (see above study).

And I don’t think women are alone. There are many awesome men who are also juggling responsibilities – working, caring for kids, being ace dads.

I once tried to talk to this about a boss I had (some time ago). His response was that I needed to go and talk to other women about this.

Some days you can get up and crank out the work – and you really enjoy it! Other days it hard. Really hard. But somehow you muddle through. Even though it feels like you are wading through mud.  The last few days I have been up at 4am trying to get work sorted so that I can be with my kids when they wake up.

Because sometimes a lot of the time, I need my kids just as much as they need me.