Health at YOUR size

quack doctorPerhaps the biggest lie that the medical establishment continues to tell fat folks is that our body size is solely (or at least primarily) our own fault; and further, that we could all permanently change our body size to a “healthy” one, if only we would make better lifestyle choices.

The second big lie is that even if we’re fat and healthy today, we will definitely be dropping dead as a direct result of our fat someday soon, just you wait!

It’s a familiar story for many of us, being judged as inherently diseased based only on a cursory glance, and being prescribed the old “treatment” of “eat less, move more” by doctors regardless of the purpose of the visit. All this in spite of ample research indicating that not only is weight loss an incredibly ineffective “treatment,” it actually does more harm than good; and that thinner is not necessarily healthier.

In this environment, when someone with M.D. after his or her name starts questioning harmful assumptions, the Fatosphere is soon abuzz with the good news. Today’s video is one example. It has been widely circulated with comments like, “How wonderful!” and “This gives me hope!”

So I clicked, and initially was taken in. Then I listened carefully a couple more times, and did some research about this physician’s work. This time, fellow fatties, I’m sorry to report that this video did not give me hope; in fact, it had rather the opposite effect.

Trigger warning: This doctor speaks frankly and graphically about his contempt for a patient he was called upon to consult with in the emergency room. He says ugly things, in an ugly way, about the body of another human being who happens to be fat.

Summary: A young doctor tells the story of how he treated a fat patient abysmally in the ER, making a moral judgment that she brought her illness (diabetes) upon herself. He then says he realized the error of his ways years later when he began to gain weight in spite of his own “healthy” lifestyle. His own weight gain apparently caused him to finally question the conventional wisdom on weight and health, and to consider a different hypothesis: that weight gain is a symptom, rather than a cause, of metabolic dysfunction. Then he tearfully shares the epiphany that fat patients are actually (sniffle) worthy of empathy and compassion because (sniffle) when they get ill, it might not even be their fault!

He talks about our humanity as if the idea were something new and absolutely fucking revolutionary. To thunderous applause.

This is the part where I get angry.

do you want a fucking medal

We’ve heard this song before though, haven’t we? Dr. Attia is not the first thin, conventionally attractive doctor to make a big show of magnanimously acknowledging the humanity of fat folks, but only after pretending to walk a mile in their extra-wide shoes:

Dr. Oz puts on a fat suit, hoping to get some empathy.

Dr. Oz does the fat suit walk. You know, for science.

“I could no longer afford the luxury of arrogance,” Attia says in his speech, just before comparing himself to Abraham Lincoln. In his new work, he says, he is leading a “team of rivals” to develop evidence-based treatment for metabolic disorders such as insulin resistance and diabetes. “I’m putting my career on the line,” he says.

So what has Dr. Attia done with his newfound empathy, compassion, and enthusiasm for challenging the conventional wisdom?

He has stopped practicing medicine and has partnered with journalist Gary Taubes, author of “Good Calories, Bad Calories” to form the Nutrition Science Initiative, also known as NuSI. There’s not much new at NuSI. So far it’s just another institution promoting the same old, tired, debunked obesi-panic. If you’re a glutton for punishment, click on over to their website. (I’ll do a more thorough commentary on NuSI in another blog post if I can accumulate sufficient Sanity Points, but I make no promises in this regard.)

Dr. Attia also has a personal blog called “The Eating Academy” where he recounts his “weight-loss journey,” a narrative which sounds like it might be yet another backwards chicken-and-egg scenario.

Dr. Attia claims to have been 40 pounds overweight at one time, and that he was experiencing insulin resistance. At this point in his life, however, he was also training 3 to 4 hours a day for elite open-water swimming events including the Maui Channel swim (about 20 miles roundtrip), and the 20-mile Catalina Channel swim, twice! Despite his training regimen and “following the Food Pyramid to the letter,” his weight “ballooned” to 200 pounds and he was beginning to accumulate some fat in his midsection. (No, seriously he BALLOONED! to a waist measurement of 36 inches!)

clutching pearls

After completing these near-superhuman feats of open-water swimming, the doctor’s loving wife told him not that he was a superhero and amazing in every way, but that he should “try to be a little less not thin.” Bless her heart.

Dr. Attia then embarks on a “weight loss journey” consisting of 1) going on a ketogenic diet, which eliminates nearly all carbs and in the doctor’s case sourced 88% of caloric intake from fat; 2) changing his sport of choice from open-water swimming to bicycling; and 3) exercising less (down to 2 to 2 1/2 hours per day from 3 to 4 hours). Yet he credits only diet with reducing his weight and waist circumference, and improving his metabolic health. Then he posts some pretty pictures of steak and salad. Yay dieting!

WAIT. Baaaaack up.

Let’s take another look at the good doctor’s self-reported lifestyle pre-weight-loss for a minute. He was engaging in an extreme sport (open-water swimming) and training for 3 to 4 hours a day in frigid water.

And yet …

Even after he had “ballooned,” I must point out that Dr. Attia did not look like any elite open-water swimming champion I’d ever seen.

Let us feast our eyes on some photos of elite open-water swimmers, shall we?

Lynne Cox, open-water badass and author of "Swimming to Antarctica" (photo from OC Register)

Lynne Cox, open-water badass and author of “Swimming to Antarctica.” Because she  actually jumped out of a perfectly good boat and swam. To Antarctica. From about a mile offshore. (photo from OC Register)



The Round Ireland Relay team, which swam 830 miles, around an entire country, in 56 days (photo from Wikipedia)

Dear readers, you will have no doubt noticed that these swimmers have something in common.

They are not thin.

In fact, some of them are VERY not thin.

Coincidence? Apparently not. Irish open-water swimmer Nuala Moore (she’s at the far right of the Irish team photo) gives this fascinating account of what happened to her and her teammates’ bodies in the course of the 56-day Round Ireland swim:

Over 56 days around Ireland while swimming 4-6 hours a day including being 16 hours a day at sea on open Zodiacs in the wind while getting soaked in the rain, we never saw a pizza or a soft drink. On most days, we gave up food in lieu of catching a tide. We pushed into the abyss. But we didn’t have anyone guiding our nutrition, except we faced the blind need to finish. We had breakfast in the morning and sometimes dinner in the evening and after 56 days we were all up 1-2 stones weight. UP! All [of] us gathered huge fat around our backs, arms and bellies despite being lean. For we were all wet and cold for 16 hours a day, but we survived. [emphasis mine]

Good heavens! It’s almost as if the human body has some adaptive mechanism to preserve life and energy when pushed to extremes of temperature and exertion!

Could Dr. Attia’s “ballooning” process have been nothing more than his body’s way of staying alive through hours of arduous swim training in the frigid Pacific?

It’s just a hypothesis, but I think it’s worthy of consideration.

Now, just for giggles, let’s take a look at some photos of elite bicycle racers.

British cyclists at the 2012 Olympics (photo from Xinhua News Agency)

British cyclists at the 2012 Olympics (photo from Xinhua News Agency)

Colombian bikers

Colombian bicycling team (photo from Fox News)

It would appear that athletes vary greatly in size and body composition, and that elite athletes’ bodes are especially well-suited to their respective sports:

photo by Howard Schatz

photo by Howard Schatz (click to enlarge)

I’m no doctor, I’m just a personal trainer. But based on the observations I’ve presented here, I think it’s worth investigating the hypothesis that if a person has a drastic change in physical activity (such as quitting an extreme sport like open-water swimming, and taking up a land-based sport such as cycling), the weight loss that follows might be primarily due to the change in activity rather than any dietary restriction.

Dr. Attia, though, is still mired in old assumptions. To him, the only thing he can see is that he got fat, he went on a diet, and that’s why he lost weight.

Chicken or egg?

What will the world look like when the work of fat activism is done? In less than four minutes, Juicy D. Light shares an inspiring vision of a world without body shame, with improved health for people of all sizes.

When I found this video, I was taking a break from writing a different kind of Film Friday post, about a video that had left me angry and discouraged. This video turned me around instantly.

I hope that you will all take a few moments to listen and visualize the world Juicy describes, and that you will join me in going out this weekend and being the change we want to see in the world.

Juicy D. Light is a fat activist, Burlesque performer, actor, and MC in Oakland, California.

This video is part of a collection of interviews from In Our Own Words: The Fat Activism History Project, by Ragen Chastain. Visit the project’s home page to view more inspiring videos and lend support to the project.

Children In Sports Attire - IsolatedAs I noted in last Thursday’s blog, The American College of Sports Medicine just held their annual Summit in Phoenix, and during the conference the Association let fly with some not-so-nice Tweets. I’ve already covered the trouble with coercive workplace “wellness” initiatives, but that wasn’t the only instance of highly problematic attitudes being spread around.

During a talk on athletic training for kids, this was Tweeted:

look like an athlete 1

look like an athlete 2

look like an athlete 3

Because this Tweet was dated April 1, it occurred to me for a moment that this one might have been an April Fool’s joke, but no. People actually Retweeted it.


I responded with Tweets of my own, pictured above, but had to stop because all I had left was furious, inarticulate stammering.

Anyone who is reading this, for the love of all that is holy do not tell your kids to look like anything but who they are. Lindy West wrote an amazing piece for the Guardian last week that gives much better advice, and to my knowledge, she is not even a personal trainer. Maybe she should be! Check it out: My hot tips for parents with a fat kid: feed them fun, kindness and dignity.

Know what? I’ll go one further: Those tips are pretty damn hot for humanity in general.
kids exercise class

lumberghThe American College of Sports Medicine (the authority whose certification is the gold standard for personal trainers, and which has certified me) is holding their 19th Annual Health & Fitness Summit & Exposition in Phoenix this week.

Fitness trainers are my people, but today I’m feeling betrayed, because some of the folks at ACSM are putting things into the Twitter stream that are downright harmful, and which have me pushing back.

Earlier today, a speaker introduced the #getup hashtag, based on a talk that encourages employers to encourage coerce sedentary employees to engage in physical activity during the workday. Here’s their Tweet and my response:

walking meetingsHello? Is the ACSM Summit so high that these trainers are not getting enough oxygen to their brains? Think about the implications of “walking meetings” in your workplace for more than five seconds and you will realize that it is a terrible idea, for myriad reasons. Here are a few:

  • Not everyone can walk. (Duh!)
  • Not everyone who can walk, can walk far or fast. When your employees are spending the entire meeting focused on putting one foot in front of the other without falling on their faces, or worrying that the pace is going to provoke their exercise-induced asthma, or just being embarrassed that they are having trouble keeping up, what kind of contribution will they be able to make to work-related discussions? Little to none.
  • Not all disabilities are visible, and employers are not entitled to medical information about employees’ disabilities unless accommodations are needed to do the actual job. For example, if Susie in Accounting has Crohn’s Disease and can’t walk a mile immediately after lunch because it would take her dangerously far away from a desperately-needed toilet, her employer is not entitled to that information. So when Susie’s boss jumps on the “walking meetings” bandwagon, Susie now has a terrible choice to make: 1) She can share her deeply private and embarrassing digestive horrors with her boss; or 2) she can be labeled “not a team player” on her next annual review because she refused to participate in this “wellness initiative” sponsored by her employer. Congratulations, boss! You have taken a well-performing employee and made her body a barrier to success for no reason.
  • Coercion is not OK. Even if your  employer is coercing you to do something that, in the end, improves your cardiorespiratory conditioning, it is still not OK, because coercion is never OK. As long as employees are performing at their jobs, their bodies are none of the employer’s business.
  • I’m sure you can think of many other reasons why “walking meetings” are a terrible idea. Feel free to share them in Comments.

Note: Please don’t think for a minute that I don’t believe in workplace wellness initiatives — I do. However in order for them to be truly beneficial and fair, they need to be both voluntary and inclusive.

book_reportDr. Deah’s Calmanac: Your Interactive Monthly Guide For Cultivating A Positive Body Image is not your typical self-help book. It is much better.

Dr. Deah is a professional with years of experience using art therapy to promote body acceptance. She holds a Doctorate in Education, an MS in Therapeutic Recreation, an MA in Creative Arts Education, and a BA in Theater.

Unlike other self-help authors, however, Dr. Deah has the experience of coming to body acceptance herself, and that makes all the difference.

In her Introduction, Dr. Deah shares several highly relatable personal anecdotes about the everyday challenges faced by folks who are just trying to Live Their Lives While Fat. In so doing, she gets me to relax into the content of the book.

The title Calmanac (calming + almanac) is apt.

The Calmanac is divided into twelve monthly segments and opens with “Personal Perspectives” from Dr. Deah, followed by “Predictable Challenges” unique to each month (e.g., holidays, bathing suit season), “Important Dates to Remember” (like International No Diet Day!), and finally, “Proactivities” for the reader to use (or not) to process their own experiences.

The writing is engaging and personal, spiced with puns and funny anecdotes as well as touching stories that bring a tear to the eye.

I bought this book in paper format even though I normally prefer eBooks, and I’m so glad I did. The cover design, typeface and layout are beautiful and hark back to the Old Farmer’s Almanac that lived on the coffee table in my parents’ house, replaced every year. Like that almanac of yore, I anticipate that I will be returning to the Calmanac frequently in the coming year.

calmanac coverDr. Deah’s Calmanac is available now.

“The Problem With Poodle Science,” from the Association for Size Diversity and Health, is a delightful video that must be shared. It is both funny and factual, and explains the HAES (Health At Every Size) approach to fitness in just under three minutes.

Of course, it also holds a special place in my heart because it echoes the Fat Personal Trainer motto (see sidebar):

You can starve a Saint Bernard, but you ain’t gonna turn it into a Greyhound.

Have a great weekend, readers. I’m planning to take my Saint Bernard body for a one-mile walk in the park. How about you? Feel free to share your plans for joyful movement in Comments.

Comeback Kid

reset buttonLate last November, like many people who got that 26% effective flu shot (or didn’t get one at all), I came down with a creeping crud that really kicked my butt. Along with the typical fever and aches, I was short of breath, with a scary cough that seemed to come from someplace down by my toes.

Normally I tough it out when I get something like this. A few days of taking it easy, drinking lots of fluids, and binge-watching Netflix takes care of the problem. However this time I actually required medical attention.

The verdict: Influenza A.

People, it was not pretty. And it was not until a couple weeks ago that I felt well enough to exercise again. And by “exercise,” today that means that I’m finally able to drag my butt around the half-mile circle road in my neighborhood and not need a nap afterwards.

Yep, my current workout regimen is a literal couch to 5K.

This experience has been hard, both physically and emotionally. I’ve come to realize that my self-perception as an athlete and trainer is tied up in being that badass supergirl who lifts heavy for an hour, then runs hell-for-leather on the elliptical for 45 minutes; and despite being human, with all the imperfections, illnesses, and injuries inherent in that condition, failure to maintain that level of conditioning (even while under attack from a nasty virus) is a source of shame and somehow a loss of what makes me, me.

Sounds kind of silly now that I’m writing it down.

This is my real-life refresher course in HAES. Health at Every Size is a practice that takes us as we are, in the bodies we live in today. It teaches us to use our capabilities (not the ones we used to have, or the ones we wish we had) and “[f]ind the joy in moving your body and becoming more physically vital in your everyday life.

Today’s half-mile was better than yesterday’s, and that is fabulous. And it is enough.


pat benatar photo by robert godwinA reader wrote to ask what kind of workout would be best to help increase her stamina. She was already a regular exerciser, but wanted to take her workouts to the next level. My mind went immediately to High-Intensity Interval Training, or HIIT.

HIIT training improves cardiorespiratory fitness and revs up the body’s metabolism, leading to increased energy as well as a kind of euphoria that is one level above the normal post-workout glow that you get with moderate exercise.

Over time, it makes you a real tough cookie.

Important: HIIT training is not for beginners. Intervals are much higher intensity than other forms of exercise and should not be attempted by people with known cardiac or respiratory issues unless they are cleared by a doctor.

When using HIIT training, it’s critical to listen to your body. The RPE (Rate of Perceived Exertion) Scale is a great tool to monitor your efforts while going through the intervals.

_rpe scale graphic

For the sake of clarity, I’m going to talk about running, but intervals are done exactly the same way whether you’re walking, biking, swimming, or using cardio apparatus like the elliptical or arc trainer.

HIIT Instructions:

Warmup: This should take at least five minutes, building up to a moderate pace. Do not skip this step! Warm muscles are much less likely to get injured during an intense workout.

Interval Part 1: Run as hard as possible for one minute. Use the fastest pace you are capable of sustaining for the entire minute. You should be at about 9.5 on the RPE Scale.

Important: do not run longer than one minute at this pace.

Interval Part 2: Slow your pace until you’re at a 6 or 7 on the RPE scale (working it, winded, but still able to speak) for three minutes.

Repeat the cycle of one high-intensity minute to three medium-intensity minutes no more than three times. You can add more intervals in a couple weeks if you want, but don’t add more than one every two or three weeks.

Cool-down/Stretch: At the conclusion of your HIIT workout, take your time cooling down and stretching, and drink plenty of water. Be kind to your muscles, and they will be much happier with you tomorrow.

Workout Planning Tip: HIIT training should be used no more than two or three times a week, with a rest day in between. If you also do strength training, it’s best to do intervals on non-lifting days.

Tech Tip: There are Smartphone apps that are specifically designed to time your interval training. Search “interval timer” at the app store. If you don’t have a smartphone, a small electronic kitchen timer will also work.

Welcome to total workout badassery.
pat benatar

The FPT Returns

It’s been about three years since I last published here. While I was gone, people stopped by the blog, they commented, and more than one person said words to the effect of, “Nice blog, why’d you stop? Please write more!”

To all of you who wrote, thank you for your kindness and support!

After a few years of radio silence during which I’ve been reading lots of terrific stuff from other writers, exploring the fatosphere, and reinventing myself as a blogger, I’m back!

Readers can look forward to more workouts, plenty of hints and encouragement for athletes of all sizes, as well as something new: social commentary. I think it’s important to talk about the fact that fat folks who work out (or do just about anything in public while fat) continually run up against cultural norms that exclude us. It happens everywhere: at the grocery store, at the doctor’s office, at the movies – hell, just walking down the street! And instead of shrinking from discussing the difficult issues, I’ve decided that I am going to need to Go There from time to time.

This is why I’ve added a new item to my bio in the sidebar: “Body-Positive Activist.”

So I hope you will join me on my continued journey. There will be posts on this blog as well as on Twitter, Instagram, and Facebook. Follow me or like my page to share in this new, improved adventure.

photo of Johanna Quaas from

If you think your age precludes you from exercising, please take a look at this photo of Johanna Quaas of Germany, who at age 86 is a competitive gymnast.

Check out these videos of Ms. Quaas in action on the Parallel Bars  and in the  Floor Exercise.

Inspired? I am!


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