Why I hate (yes, hate) going to the doctor and why I go anyway 

As a white, cys-gendered anglophone in Canada I have many privileges. This post is about how, despite those privileges, I truly hate going to the doctor. 

It is the 1980s, I am a child at the pediatrician my mother asks why there are folds of skin in my armpits. “Babyfat, it will go away.” assures the pediatrician. In fact it is breast tissue. I find out when nursing my first son in 1999 as milk leaked from my underarms that I have breasts under there. 

It is 2009, I am sitting in a public health clinic room to have my pap. I’ve answered the medical history questions and the nurse practitioner stares at me. 

“How many sexual partners have you had?”

“My whole lifetime? I don’t know. I didn’t keep a list.”

“Well, if you had to guess.”

“I guess about 30. ”

“30!?! Who is the father of your children?”

“My partner.”

“What? How?”

“I’m sorry you are confused. I’m married to a man, who has a penis, that I have sex with that I refer to as my partner. We are the parents.”

It is 2004, I am sitting in the military hospital getting medically released after 12 years of service. My doctor talks to me about my mental health, my asthma and my bloodwork. He scribbled a fourth thing on the list but does not discuss it with me. I read it at home. 

Image of a medical firm listing illnesses and injuries. The list states major depressive disorder, mild exercise induced asthma, borderline cholesterol and obesity.

It is 2012 and I am at a colposcopy clinic for an abnormal pap follow-up. The nurse asks when my last period was. I didn’t know. She asked what birth control I was using. I said none. She chastised me for taking risks with being pregnant. I knew I wasn’t pregnant as my partner had a vasectomy and I had a tubal ligation in 2001. It never occurred to me that this was “using birth control”.  I explain my misunderstanding to the nurse from my feet in the stirrup position. She further castigated me as pregnancy could still occur and how would I know if I didn’t track my period? I explain I didn’t think my uterus required constant supervision. 

There are so many more moments that are flooding back to me as I write this but you get the idea. 

When I go to the doctor I feel on the defense right away. My body is deemed too heavy. My blood somehow lacking or having too much of the wrong things. There is something wrong and more often that feels on my part like the something wrong is my whole self. It’s terrible. 

In the military I was regularly categorized, measured and tested to ensure I was fit for flying duties. Many years later I feel the complicated things about not fitting expectations or having medical issues. 

I go anyway because not accessing care is why queer women have worse health outcomes than other women. 

I go because my health is worth the effort and I’ve honed and prepared my responses for when medical professionals cross a line. 

I go ready for a fight. I hate that too.

The Flu and My Friend’s Fitness Journey (Guest Post)

Last week I got unexpectedly hit with the flu. (Come to think of it, is it ever really expected?) Anyway, it knocked me out hard and I was upset by the rough start to my 2017. (Needless to say I haven’t worked out but proudly made it to a Yin yoga class which my post-flu body could barely handle.)

While I’m not one for New Year’s resolutions, I do appreciate a New Year’s reflection on my overall life trajectory. What have I accomplished? What haven’t I? Where would I like to see things going over the next year?

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New Year’s resolutions for me, like lots of people, tend to fall flat by Week 2. Sam wrote about December 1st as the new January 1st. I actually like the idea of getting a jump on a new year the months leading up to it.

In the fall, I was excited to recommit to my health and fitness. I’ve written here about how I am learning to see myself as an active person who is takes her wellbeing seriously. One of the people who inspired me to make the change in my own life also recommitted to her health and wellbeing exactly one year before I did (she in November 2015, and I in November 2016).

I thought that I would speak more formally with her about her experience, as there are things I recognize as similar about both of our stories: we both started out as relatively active children and young women but became discouraged and anxious about fitness as we got older. We both had multiple false starts over the years, and we both decided to integrate fitness and wellness in our lives around the same time.

 

Tracy: What does being “fit” mean to you?

Jaclyn: Being fit means loving, embracing and accepting my body for all the amazing things that I can do. This is not to say that now I love my body because it is leaner and has more muscle mass, and that I could not love my body before because I had a much higher body fat percentage. Getting stronger, lifting heavier, and getting my cardio up to a level I didn’t know was possible has led to an appreciation for myself and my body that I never had when I spent most of my days drinking, partying, and subsequently binge eating my hangover away the next day.

Tracy: Since you mention it, regarding your drinking/partying in the past, do you feel like you simply “replaced” those old habits with new ones or is it more complex? (Do you feel like a different person now than you were back then?)

Jaclyn: I think it’s more complex than that. I’m the same person, yet a different person. I think a part of the drinking was me trying to cover over parts of me that I didn’t like (or that I thought I needed to change to be liked). When I began my fitness journey, my new habits (nutrition, fitness, sleep, water intake, etc.) replaced old habits (binge drinking, binge eating, partying).  As my new habits began to slowly weed out and replace my old ones, there was a moment that I realized I was truly and genuinely happy. In that moment, I realized that this new lifestyle fuels me and allows me to be my most authentic and genuine self.

Tracy: That’s so wonderful and it’s been amazing to see your progress. What was your previous experience with fitness? Were you an active child?

Jaclyn: I grew up an active kid; I was on the swim and synchronized swimming teams, played soccer, and did ballet. My family loves to camp, so I’d frequently go canoeing, hiking, swimming and kayaking with them. But gym class was a nightmare for me. As a shy and introverted child, cliques in gym classes (which often involved choosing partners and teams) intimidated me. My intuition was to skip the classes to avoid this.

In undergrad, I joined a couple gyms but never stuck with them because I had no knowledge about what I should be doing, how to use the machines and free weights, or how to bring variety into my workouts and how to eat in accordance with my goals.

I would never even dream of asking someone to show me how to do something, and I was too afraid of being judged using free weighs since I had never used them before.  So, I would go over to the one machine I knew – the treadmill – walk for 40 minutes and leave as quickly as I could.  After a couple weeks, I would get bored of the same old routine and frustrated by the lack of any tangible kind of progress, I would quit the gym.  Looking back, my social anxiety, shyness and introversion were the biggest obstacles for getting into fitness.

Tracy: I think that can be quite common—sometimes people see “gym culture” as macho or unfriendly, especially for someone who is new to working out or not that knowledgeable when it comes to fitness. How did you find this and what strategies did you find helpful in overcoming that?

Jaclyn: As someone with little knowledge about fitness and exercise, and as an introvert with social anxiety, breaking into the gym and developing a consistent routine was a huge obstacle. This time, however, I didn’t want to run; I wanted to face this challenge and move myself into a space where I could walk into a gym and do my routine comfortably.

As I’ve grown with my anxiety, I have learned things that I can do to help reduce attacks.  For example, in a conference setting, the more research I have done on my topic, the more comfortable I felt.  So, this was my first strategy in wanting to become more comfortable at the gym, to gain knowledge.

I’m fortunate that I could afford a starter package with a personal trainer.  My thought process was that if I was willing to spend the money I previously did on booze, then I could certainly take that money and invest in myself and buy some training sessions.  I thought that if I had an expert take me through the gym, show me how to use the machines and show me some free weight exercises, I would feel more confident walking in and doing it on my own.

Further, I thought that if I could learn the basics of form, that when I went on my own I would be less likely to injure myself.  Another alternative to training packages is to take full advantage of the growing fitness industry via social media platforms (such as YouTube). I used this to watch how certain exercises are done, would mimic the motions in the privacy of my own house, and then try them at the gym. Utilizing the knowledge from the training sessions and from my research online helped me feel more confident in the gym.

Tracy: You’ve mentioned your social anxieties, which I think are common for many people, especially when it comes to trying new things. How has fitness allowed you to grow in this area, and allowed you to become less fearful of being judged, etc.?

Jaclyn: In addition to gaining the knowledge necessary to make me more comfortable at the gym, I made sure to go during quieter periods (i.e., not during peak times), especially at the beginning. I would also wear a baseball hat, which almost acted like blinders—it helped me feel more “in the zone” and focus more on myself and less on others around me.

Over time, I became more and more confident in myself and in my place at the gym. The better I became at lifting, the less I worried about being judged.  Moreover, the more I fell in love with lifting, the less I cared about being judged; in fact, I don’t worry at all about this because I know that weight lifting involves stalling on reps, or failing a certain move.  I know saw failure as opportunity to grow and learn – understood that this was part and parcel of the process itself – and so I no longer feared being judged.  This process of working on my anxieties in the gym was by no means a speedy one, but I can now happily say that about one year later, I do not need to wear a hat, and I can walk into any gym, at any time, and get to the grind with no fear and no anxieties.

I found that this newfound confidence in the gym spilled into other aspects of my life.  Looking back at where I started and where I am now made me realize how strong and resilient I am.  It helped me realize what I want out of life, and what I wasn’t willing to compromise.

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Tracy: What surprised you most about the new lifestyle that you wouldn’t have expected?

Jaclyn: I never expected to fall in love with fitness and weightlifting like I did, but perhaps more surprising was the humbling self-love and acceptance that arose naturally out of the process.  I have cellulite and big thighs, but this no longer bothers me like it used to.  Instead, I am amazed by how strong and resilient I have become since I started.  I have become humbled by fitness and developed a love for myself that was absent from the larger part of my life.

Jaclyn is an aspiring fitness blogger, living in London completing her PhD in philosophy of neuroscience at the University of Western Ontario.

This interview has been condensed and edited.

Speaking with Jaclyn over the last few months have helped to keep me both motivated and patient with myself. It’s especially helpful when I have my own hang-ups or things that slow me down—like the flu, or like fainting (which I wrote about in last month’s post). I’m grateful to have her as a friend and role model and thank her for letting me write about this so openly in this month’s post!

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Mood Swings (Guest Post)

I’ve written before about how I use exercise to manage my mild anxiety and depression. I know I’m not alone in using exercise to manage not only my mental health, but also regular emotions. After all, if I were, rage yoga and countless motivational posters telling you to work out your anger wouldn’t exist.

Often, I use more “conventional” types of exercise – running, swimming, weightlifting…even just taking the dog for a walk and breathing some fresh air for a bit. I’ve also written before that I often struggle to motivate myself to actually go do these things.

And yes, I do take pride in being able to push myself to go put on my shoes, to hit the pavement, to jump into the deep end. But I’m also an advocate for the idea that you should do the exercise you want to do. If running isn’t your thing, don’t run. Find something else you like, and do that. And whatever that thing is, it doesn’t matter whether it’s conventional or not – just go do it. Haters gonna hate.

All this brings me to what has been my saving grace over the last couple of weeks: the humble swing set.

Every day, on my walk home from my university, I pass through my city’s botanical gardens, where a simple two-seater swing set stands by the gate. Rather impulsively, after a long and annoying day filled with interpersonal drama, thesis-writing woes, and the (then still-unfolding) election of Donald Trump, I threw my bag on the grass, plunked down in the seat, and started to swing. I hadn’t swung in a long time, and was surprised at how quickly a few pumps of my legs got me as high as the swing would go.

Something I never realized as a kid was that swinging is actually pretty physically engaging. Pumping your legs back and forth, hanging onto the chains so you don’t fall out of your seat, that slight lean back as you swing forward, pressing your chest forward as you swing back: my arms, legs, back, and abs could all feel it. Sure, it’s not weightlifting or triathlon training, and it may be a sign that I need to exercise more than I do, but I was surprised at how demanding swinging turned out to be.

It often happens to me that I don’t realize how I’m feeling until I’m moving. Exercise helps me think through problems and channel my energy into something productive. I’ve always been drawn to repetitive pursuits: knitting, swimming, running. These activities offer me a chance to tune out for a little bit. I find comfort in the repetition, which quiets the part of my brain that would normally dart around from one thought to the next, and lets me sink into more focused, calmer reflection. It shouldn’t be surprising, then, that swinging back and forth does exactly the same thing. The gentle rise and fall, the rush as you swing through the lowest part of the pendulum. Easy, predictable acceleration and deceleration. I’ve returned to the swing set a few times in the last few weeks because I find it calming and cathartic. When I’m angry, a few minutes of going all-out on the swing set is a surefire way to tone down the anger and start reflecting in a way that really gets to the heart of why I’m angry, think about what I can do about a situation, or work my way through a philosophical problem I’ve encountered while working on my thesis.

But there’s another benefit to swinging that keeps me coming back to that swing set, and it’s probably the most important aspect: swinging is really, really fun. Pushing harder, seeing how high you can make the swing go, falling through the air without fear of getting hurt. Is it any wonder that children flock to swing sets? They’re exhilarating! The physical activity helps me control my emotions, surely. But doing something just for fun is pretty great, too, and I think that part of swinging is at least as beneficial as the physical activity.

One of the swing sets I visit occasionally.

One of the swing sets I visit occasionally.

Chloe is presently completing her PhD in philosophy. When she’s not busy writing, she can usually be found knitting, gardening, cooking, sewing, stargazing, or lifting heavy objects.

Finding my fitness spirit animal (Guest post)

I have figured out my fitness spirit animal.

My desire to get in better shape has been a long time coming. I’ve always dreamed of being the kind of person who truly enjoys physical activity, who opts for a salad instead of something crunchy and deep-fried. One of my good friends is one of these people. It seems to come to her naturally—she runs marathons for fun and honestly enjoys vegetables. She often says that her spirit animal is a hamster because she can relate to the need to run on a wheel that doesn’t go anywhere—just to burn the energy.

I envy these people. And I cannot relate to them at all.

In the past I’ve related most closely to lazy housecats. Or maybe to a blubbery seal sunbathing on a rock with half-eaten fishtail dangling from its mouth.

 

seal-on-rock

This is how I spent much of the last two years: sprawled out on my couch with Netflix and a family-size bag of chips balanced expertly on my chest. (For you non-snackers, a family-size bag is much bigger than a regular size bag.) I was going through some intense stuff in my personal life and so hibernation seemed the most sensible option for a time when I was feeling so emotionally raw. And don’t get me wrong…I do have some fond memories of nights alone surrounded by blankets and snacks, like any happy seal would. I don’t regret this perhaps necessarily indulgent time in my life. But the problem was that it became a fairly regular habit. From “What the heck, just this once!” to “Oh, maybe I’ll only indulge on weekends,” to “Well, Thursday and Friday are basically the weekend,” and so forth. You get it – it got out of hand.

I think part of the problem was also that I viewed myself as a very physically awkward person, so anxiety around my own physical awkwardness prevented me from taking action sooner. I just never thought of myself as an “athletic person.” And this would always be reinforced when, in the past, I’d be working out and feeling strong and graceful, only to catch my reflection in an ill-placed mirror and suddenly think, Oh God! Is that what I look like right now?? (Have you ever seen a seal try to get around on land? It ain’t pretty.)

 I mean, I probably suffer from an average degree of female-related self-consciousness about my body, but the combination of athletic anxiety and my perceived physical awkwardness didn’t help.

Who knows, maybe it’s that “fitness clothes” (bright and skin-tight) just aren’t that flattering on bodies like mine (soft and curvy with doughy bits). Don’t get me wrong, I do love my body and have admired myself in many a reflection on a good day—I even considered entering a burlesque show once—but by today’s standards of “fitness,” or what it means “to be fit,” I often see myself as too round, soft, and flat out awkward to be an “in shape” person. And it doesn’t help to see people with gazelle-like grace running past me on the street while I get sweaty just from walking around with a backpack on. My idea of what it meant to be active had become too dichotomous.

However, during my time of hibernation, another friend of mine had completely transformed herself from a hard partyer to heavy weight lifter. It was inspiring to see her journey and what appealed to me most about her story was that she had done so with no previous experience or even inclination to make such a change. When I asked her about her experience, she told me that she too had been initially intimidated by fitness culture and by gyms, never daring to try more than the elliptical or treadmill. But the real clincher for me was when she told me she still indulges in homemade desserts and other delicious treats every night. She still has nights sprawled out on her couch with Netflix.

It was a revelation.

Never before had I meant a healthy and fit person with the same lazy, snack-fueled inclinations as myself.

Image result for hamster on a treadmill

I used to think there were two kinds of people: the gazelles and the hamsters of the world who love to run and don’t eat junk food, and the housecats and blubbery seals like me, doomed to lie about on our rocks and couches indefinitely. And while I know that different people have different inclinations (health- and activity-wise), it took me a while to realize that “fitness” is a wide-ranging sliding scale.

I used to think that being healthy and fit meant pretty much never eating fun stuff again, never lazing about guilt-free again. And this would mean that becoming healthier would be changing who I am and giving up some of the things I truly enjoy. It hadn’t occurred to me that incorporating fitness into my life would be about harmonizing my internal athlete and couch potato, my inner hamster and housecat.

While so much of the culture around “being fit” can seem impenetrable, exclusive, and intimidating—especially for someone who has never known quite how to go about it—finding someone who had found a way to take control of her health and wellness in her own way was eye-opening for me. I just had to find my own way that worked for me.

Strangely, I had been afraid that becoming healthier and more active would mean losing a part of myself. But what I learned was that I had it in me the whole time. My fitness spirit animal is still 100% a blubbery seal. But here’s the thing about blubbery seals, they know how to relax on land, but they get down to business under water. They are my fitness spirit animal: the perfect combination of awkward and graceful, blubbery and strong, lazy and active.

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Tracy de Boer is a real adult lady currently living in Toronto and completing her PhD in political philosophy at Western University. She is passionate about the ways philosophy enables people to think critically about everyday life. She is also very sad about the results of the U.S. election. You can find her on Twitter and Instagram, @tracyrwdeboer.

 

Stop flossing right now? Or not…

I loved the list of 40 things you can stop doing right now. It included peeling vegetables before you cook them (duh) but also a bunch of personal health related things such as getting eight hours sleep all in a row (it’s okay to wake during the night and go back to sleep, in two stages), drinking eight glasses of water, and flossing. My favourite that is all on all of these “don’t bother” lists is stretching.

I loved the list because we all think there are so many things we all think we have to do when it comes to our own personal health. The health related personal demands on the individual are pretty high right now, whether it’s getting 10,000 steps, or eating 10-12 servings of fruits and vegetables a day. Call this list of demands the health imperative. It’s a feature of the society in which we live. It’s about individual responsibility for maintaining a healthy body and it’s a lot of work.

We assume there is good evidence for disciplining our bodies in all these many ways, but what if the evidence for a practice just isn’t there?

In August, the British Dental Association’s scientific adviser declared flossing to be pointless, adding that all floss-based studies of the past 25 years have been of “very low quality”. If you’ve never flossed your teeth, you were right all along. Go out there today and flash the world that foul-smelling, grey-green smile of yours. You’ve earned this. (from the 40 things list)

Here’s the LA Times piece on flossing,

When the federal government issued its latest dietary guidelines this year, the flossing recommendation had been removed, without notice. In a letter to the AP, the government acknowledged the effectiveness of flossing had never been researched, as required.

The AP looked at the most rigorous research conducted over the last decade, focusing on 25 studies that generally compared the use of a toothbrush with the combination of toothbrushes and floss. The findings? The evidence for flossing is “weak, very unreliable,” of “very low” quality, and carries “a moderate to large potential for bias.”

What does this mean for you? Well, floss if you want to but don’t do it because you think you ought to. You get no credits in the self-care column when it comes to flossing. Maybe you just like the feeling of clean spaces between your teeth (I get that) but if you’ve been doing for reasons of dental health and hating it, now might be the time to stop.

Rebecca Kukla (who guest blogs here)  recently posted to Facebook about flossing when the dentist was busy advising her son to floss. She admitted she was tempted to give the dentist a lecture about evidence-based medicine and about patronizing science-free advice that impedes epistemic agency.

Frankly, I was surprised at the many defenders of flossing who cropped up. Not defenders of the practice (it’s okay, floss if you want to, see above) but defenders of the imperative, the claim that we ought to floss. After all the articles above don’t say that flossing doesn’t work, only that the studies that it set out to show that it benefits offered very little proof. It still might be the case that flossing is really important. (Of course, it might also be really important to hop on one foot and howl at the moon. We just don’t know. The evidence is weak but ti still might be true.)

The debate on Rebecca’s page went on, so many defenders of flossing, and I loved her response and I’m quoting it here with permission.

“People who are standing up for something like the “floss because it can’t hurt and maybe it will help even though science hasn’t managed to show it” line: If you like flossing (I do after corn or bbq!) then by all means enjoy it. But here is the problem. Medical and other institutions are constantly adding countless things that we ‘should’ do ‘just to be safe’ despite minimal or no evidence of benefit, and then these get weirdly moralized, so you’re an irresponsible person/parent (especially parent!) if you don’t do them. Each one may be small but we can’t POSSIBLY do all of them. We would have no life. They accumulate. So at some point you have to recognize that through sheer number they become micro-aggressions, in effect. If there is no evidence for something helping, the most you should say is “Well it seems unlikely to hurt [assuming that’s true; it isn’t always] but it’s really up to you.” This ‘It’s important that you do it just in case it helps’ bullshit has got to stop. And it is disproportionately directed at mothers of course.”

That’s what I like about the 40 things list. It urges us to relax, and to push back against the health imperative. And for good God, stop measuring all the things–drinking EIGHT glasses of water, sleeping EIGHT hours a night, eating TEN TO TWELVE servings of fruits and vegetables, walking TEN THOUSAND steps, flossing ONCE a day and so on and so on. Also, for God sake, stop with all the measuring! Enough! (Don’t get me started on weight, percent body fat. and BMI. See this a guest post from this weekend about all that.)

I had a roommate in grad school who every night confronted her own personal health imperative dilemma, sits ups or flossing? Every night we’d finish our work, work some TV, and then the debate would begin, which would she do, sit ups or flossing? She’d committed to one or the other each night. Luckily the standard issue sit up has also been debunked so now she can relax.

How do you feel about the very long list of health related things we all ought to do? Do you agree with Rebecca that the list of demands hits mothers worst? What, if anything, are you knocking off your list?

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Unpacking the ACSM’s Body Composition Table (Guest Post)

In my Advanced Physiological Assessment class the other day, we conducted a body composition lab which measured body fat using a variety of clinical assessment tools including bioelectric impedance analysis (BIA), underwater weighing (UWW), and DEXA scanning. 

These tools use either electrical currents, x-ray scans, and Archimedes’ Principle to measure body density which is then converted to body fat. The conversion formula is then selected based on race, age, and gender, with many groups that are underrepresented. 

As a white, 21-year-old female, I was privileged in that there was a formula that was representative of my body. While the methodology is a little different, all of these tools rely on the principle that fat is less dense than water, muscle (which has a lot of water), and the other components of fat free mass, like bone and soft tissues. Some of these are pretty good assumptions, while others, like bone density can be highly variable.

On lab day, I was pretty excited. I am a 21-year-old competitive cyclist and triathlete, and as an exercise scientist, I am genuinely curious as to how my numbers compare to population norms and other athletes (to give you an idea, I voluntarily did a lactate threshold test which involves having your fingers repeatedly pricked during a graded exercise test just for funsies #nerd). I followed the protocol as best I could, holding my arms straight out and standing tall during the BIA, exhaling ALL of my air during two trials of underwater weighing, and laying perfectly still during the 7 minute DEXA scan. 

I will note that I was not able to follow all of the BIA protocol which includes no eating or drinking four hours prior. After running the numbers, I was completely astounded as to what the ACSM, the American College of Sports Medicine, that is, classified my body fat % to be. Turns out, depending on the method used, I’m either “good,” “fair,” “poor,” or “very poor.” Here’s a brief breakdown of the results:

Height: 170 cm

Weight: 64 kg

BMI: 22.2 = normal

Hand-Held B.I.A. Body Fat % -regular: 22.3% (Fair, 42nd percentile)

Hand-Held B.I.A. Body Fat %- athlete: 22.2% (Fair, 42nd percentile)

Scale B.I.A. Body Fat % -regular: 28.9% (Very Poor, 15th percentile)

Scale B.I.A. Body Fat % -athlete: 24.3% (Poor, 31st percentile)

D.E.X.A Body Fat %: 24.7% (Poor, 30th percentile)

D.E.X.A. Bone Mineral Density: 1.103 g/cm^3 (Normal)

Underwater Weighing Body Fat %: 19.2% (Good, 62nd percentile)

The rest of the classifications are “very lean”and “excellent.” There are so many problems with this that I hardly know where to begin.

First, the 2010 ACSM Body Composition Table for Women developed these norms based on patients from the Cooper Clinic in Dallas, Texas. As my professor pointed out in class, people who have their body composition measured tend to be rather self-selecting- athletes looking to “cut weight” for sports or individuals on weight loss programs to see how much fat loss is appropriate. 

The Cooper Clinic is a medical center that specializes in “comprehensive preventive exams.” By looking at this chart, I can only assume that they have a “very lean” patient base if the 50th percentile for a female between the ages of 20-29 is 21.0%. In fact, my most accurate number, which I will assume is from the DEXA scan, wouldn’t be exactly average until I was 40. Anecdotally, most of my female college of health sciences peers have body fat percentages around 25%, which is likely lower than campus as a whole. One would think that surely, this is the result of a small sampling base, but no, the listed sample size for my age group, 1360, with a total sample size of 12,116 for all females. If the average female wears a size 14-16, and I wear a size 4, it would make sense that I would be more towards the left side of the bell curve. The American Council on Exercise classifies obesity for women as having a body fat of 32% or higher. The ACSM chart stops at 38.9% for 20-29 year old females and 40.5% for 70-79 year old females as being the top (fattest) 1%. If 64% of American women are supposedly overweight or obese, these “norms” are clearly NOT representative of the United States female population.

The second problem with this chart is the very narrow classification ranges. I completed all four tests within 30 minutes of each other and got a wide range of results. On the 2010 ACSM chart, a difference of 2.6% moves you from the midpoint of “poor” to the midpoint of “fair.” I had a 2% difference between the scale and handheld BIA when they were both on the “athlete” setting. With such varied results, how can healthcare professionals make recommendations using this chart in good conscience?

Finally, the classification terminology is demoralizing and clinically meaningless. I would like to point out that essential fat, the fat that is necessary for normal healthy functioning for females is around 12-14%. Without it, your organs, central nervous system, muscles, and brain would not function. On this chart, values lower than that is not called “anorexia,” but “very lean”. Which, if you’ve listened to the health/fitness/diet industry lately, “very lean” is what we should all be striving for, right? I will concede that there is an asterisk next to the “very lean” classification that does state that body fat percentage less than 10-13% is not recommended for females. I will argue that “not recommended” doesn’t even touch the gravity of that lethal situation. That should be a call for medical attention. 

Unfortunately, “very lean” is the only descriptive term used on this chart. “Excellent,” “Good,” “Fair,”  “Poor,” “Very Poor” are completely subjective terms that have no clinical significance whatsoever. They are fat-phobic and encourage the orthorexic ideal that a lean body is the only kind of good body. I’d like to emphasize that this is the chart for the American College of Sports Medicine, the most respected medical organization that writes health and fitness recommendations for the general public. These are doctors, researchers, rehab professionals, professors, and trainers that rely on their information to make well-informed decisions regarding patient care every day.

There are other normative charts available, like the one mentioned above from the American Council on Exercise, although their terms, “essential, athletes, fitness, average, obese” aren’t much better. I’ve seen a similar chart where “average” is replaced with “acceptable.” I know many athletes who have body fat percentages much higher than mine. They are no less, perhaps even better, athletes because of it. I think that statement gets to the heart of the problem. What exactly is an acceptable body? Is it one that is healthy and functions as it needs to? Or is it just a thin body? If we rely on size as a quick indicator of good health, we’re not even measuring what is actually indicative of cardiovascular health- how the heart, lungs, and muscles work together. I know that my “poor” body fat percentage doesn’t mean I’m unhealthy- my other physiological markers such as blood pressure, lactate threshold, cholesterol and VO2 max all show that I have excellent cardiorespiratory fitness. My behaviors (which are perhaps even more indicative of long-term outcomes) like engaging in regular aerobic and strength training exercise, eating a healthy balanced diet (I like something similar to 80/20), taking time for self-care, not smoking, and getting enough sleep agree with that.

Fortunately, the ACSM has updated many of their exercise prescription recommendations as of 2015. Some updates are expected in 2017, but I am not sure if the body composition norms will be included. For now, I’m taking these results with a grain of salt. I know that despite what the ACSM has to say, my body is good, acceptable, perhaps even above average no matter how much fat I have.  

The author carrying her bike up a hill at a cx race

Charging my way up the run up at the Boone Town Throwdown CX race!

Vacuuming as exercise, and other myths about women’s mobility

For some time now women have been told that housework chores can count as exercise, but for reasons unknown I’ve only just cottoned on to this self-help trend. Vacuuming, gardening, washing the floor, hauling the laundry up and down stairs… is it exercise? Some say yes (click here for a representative, if slightly condescending, example); some say no (this example comes from Women’s Health, and is actually even more condescending than the Weight Watchers example.)

I have two replies to the question, personally.

Is housework exercise? HELL YA. Have you ever hauled three loads of laundry up the stairs in between pulling out dead perennials and cleaning up after the dog? It’s a lot of fecking hard work, and I sweat through it weekly.

Is housework exercise? HELL NO. Because it’s WORK, people! It’s unpaid labour for many women, and poorly paid labour for many others. Don’t condescend to us by equating it with self-care. That way madness lies – and nothing but patriarchal double standards.

 

So what to do with this information then? How to learn from the “housework as exercise” trend, and the arguments underpinning it?

In my job as a humanities scholar, I spend a lot of time with students parsing popular culture and the discourses that drive it. This isn’t just something we do to pass the time in class and prepare for essays that will eventually go in the bin, forgotten; parsing public language is an essential life skill, a citizenship skill. It teaches us to be skeptical of the messages we get everyday from the world around us.

(Think about it: if everyone had some basic message-parsing skills, would Donald Trump be the Republican candidate for president? Or would we be witnessing a proper, grown-up campaign for the most important political office in the world?)

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Is the campaign trail exercise, Hilary? Um, DUH. It’s also HARD WORK.

In the two short articles I link to above, my trained parsing brain reads the following embedded assumptions:

  • women should always be focused on weight loss; this is typically dressed up as “exercise” in the press to make it more modern and palatable;
  • “exercise” is something women need to make time for; if they don’t have time because of housework chores, they shouldn’t worry about it, but rather repurpose their housework as “exercise”, or even as “me time” (doing squats while waiting for the microwave! As if!);
  • housework is not work, because it’s “exercise” (aka “me time”);
  • women snack too much when they work hard! Stop snacking, ladies! Next time you grocery shop – because of course YOU grocery shop for your family, right? – be sure not to buy so many salty, fatty snacks that you enjoy!
  • women have no impulse control (see directly above), and therefore need to be reminded both to exercise and not to snack;
  • housework is a fact of life. Get over it, ladies.

What’s common among all these assumptions? Basic gender divisions: it’s not men doing the housework in the images in these articles; it’s fit, able-bodied, white, pretty ladies. There’s no notion here that you might, um, ask your partner to help with chores, or simply let the dirt accumulate a bit so you can do something else you enjoy, move your body in some other way. Instead, there’s a blanket assumption that you have to do the chores (it’s natural! It’s the way life is for us gals!), and you obviously have to exercise (keep young and beautiful, if you want to be loved!), so what else to do? (Just don’t eat any crisps while you’re at it, because then you’ll get fat and your husband won’t want you anymore…)

What’s the alternative to this coercive set of barely-spoken assumptions? I want to propose a totally different way of talking about the issue of how housework impacts women’s lives, and what that has to do not with exercise, but with mobility.

I’d like to suggest instead that, as women, whether single or partnered, disabled or non-disabled, in traditional relationships or in non-traditional ones, we all spend some time this week not squatting in front of the microwave, but rather thinking critically about how we move each day, how and why our movements are circumscribed, and how we might find ways – with the help of partners, family, friends, employers, or others – of becoming more mobile, on our own terms.

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Here, I want to stress that it is not our job alone to become more mobile, or to overcome socially-driven mobility constraints; we live in a world in which institutional constraints actively work to limit women’s mobility, especially non-white, disabled women’s mobility; those institutions must change in order for mobility to become more broadly equitable for everyone. Mobility is a societal responsibility, not an individual one.

But part of that work needs to be activist on our part, needs to be about us making noise; it needs to start with all of us recognising and deconstructing where and how we are, and are not, freely mobile, and to complain, loudly, when our mobility is unfairly limited – whether because of wheelchair access barriers, or because of media messages that tell us to keep doing that laundry, it’s good for us!

I challenged myself to keep tabs, for a week, on my own daily mobility, to see where I’m free to move in ways that I wish, and where I’m not so free. Here are my findings from last week, generalised a bit to a normal term-time week:

  • I usually wake up between 8am and 9am; I’m lucky to have a job that works with my circadian rhythms, so I recognise here I’m very privileged to get up without an alarm clock at least 4 times per week. That means I’m better rested and more energised.
  • next, I walk the dog; she insists, but it’s not like she’s the boss. I could say no! But I enjoy my three walks a day with her, again because I’m privileged to have a flexible schedule.
  • on teaching days I cycle to my campus office around 11am; I live in a walkable, ridable city (more privilege). I teach between two and four hours a day twice a week; I’m on my feet for half of these, sitting down for the other half. No choice there. Often I’ll wear high heels for teaching, though this is largely my choice; nevertheless, I feel compelled to present as broadly feminine in the public sphere, so it’s not all my choice. The heels can produce standing discomfort and occasional hip pain.
  • a good portion of the rest of my weekly labour (teaching prep; administration; research – profs work a lot, and teaching is just part of it…) is at a computer, sitting; I’m lucky to have good chairs and the freedom to get up and move around a lot during this work (see dog walking, above).
  • late afternoons / evenings I usually cycle or row for up to two hours at a time. This represents remarkable freedom of movement, as I have no partner or children demanding access to my time or body at home.
  • evenings I often work at my computer at home, catching up on things dropped in the day. I can stand up and move around during this work but often I don’t. Because I have no partner or children pressing on my time or mobility, I often forget to get up and stretch. This is a mixed blessing.
  • weekends include housework, cleaning, gardening, marketing. These are my choice, but I feel social pressure to keep a neat house and garden, so they are not all my choice. Even more because I have no nuclear family (IE: I’m not “heteronormative” in my living conditions), I want to appear “normal” to my neighbours, and so maintain the outward appearance of a middle-class professional woman in all of my “front stage areas” (this term comes from the ethnographer Erving Goffman).
  • on Sundays I often see my parents, who are elderly, and support my mom, who is in a wheelchair. Because her mobility is so limited I become a surrogate body for her while I’m helping out. This is the closest I come in my daily life to understanding what so many women who are caregivers for children, parents, or partners go through all the time. Taking orders from mom, and moving her around the world using my body, are a lot of work; I compromise my control over my own mobility in order to give her a bit more freedom. I am so lucky to be fit and strong, because the physical demands on me in this labour are tremendous.

It’s obvious from the above that I’m very, very lucky with my mobility in general: it is largely my own to determine. Kids don’t demand I be here or there at this or that time, or that I give over my bodily movement to their needs; ditto with a partner. I have a flexible job and can do what I want when. But socially, I’m still constrained as a middle-aged woman who lives under the glare of heteronormativity. Weekend chores mean less time overall for relaxing – which impacts my health a bit. And, as a result of not having a partner (partly due to the fact, I’m afraid, that I’m in my 40s and have an advanced degree and a professional, intellectual job… intimidating for a lot of guys), I also don’t get regular sex; that’s a key way in which I do not move that I wish I could move more often.

How about you? In what ways is your mobility constrained, and in what ways are you free to chart your daily and weekly course? Try the tracking exercise and share your findings; I’m keen to hear about others’ experiences.

Finally, let me stress once more: this is not about changing ourselves; it’s about charting how institutional and other pressures in our lives keep us from moving freely – and how that impacts, among other things, our ability to exercise and to rest our bodies how we want, when we want.

Kim