fitness · health · Weekends with Womack

Language matters: how words in health contexts can hurt

CW: talk of fat-shaming and weight connected to health (for purposes of describing my presentation). The past two weeks have been conference-intensive. I was in Guelph, Ontario a couple of weeks ago, listening to talks about Feminism and food and also hanging out with our blog founders and friends Sam and Tracy. I mini-blogged about some of the talks here.

This past week, I was giving a talk at the American Public Health Association Meetings in Philadelphia. It was about health-concern trolling of fat people in the doctor’s office and other healthcare contexts. Spoiler alert: I’m against it.

What do I mean by health-concern trolling? Think of it as fat-shaming speech justified by health concerns on the part of the speaker. Here are some common examples:

  • I’m just concerned about your health.
  • You’d find that life was a lot easier if you weighed less.
  • (insert any disease or condition here) would be less severe/go away/never have appeared if you lost weight.
  • Before treating (insert any disease or condition here), you need to lose weight.

But of course images speak volumes. You’ve seen it before, but it’s a classic:

Comic of a woman impaled on a stake, and a doctor telling her she’d do better if she lost weight.

Apart from the big problem the woman in the comic has, how does health concern-trolling harm us? I think (as do others working in feminist bioethics– there’s strength in numbers…) that it’s a form of microagression, which wears us down with the repeated message that we don’t matter as patients, as persons who deserve respect and care.

What do I mean by microagression? This: A microaggression is a relatively minor insulting event made disproportionately harmful by taking part in an oppressive pattern of similar insults. The pattern of insults tends to be linked to stable traits such as gender, ethnicity, disability status, or (in this case) weight. Philosopher Regina Rini explained the harms of microaggressions well here:

What makes microaggression distinctively harmful is victims’ awareness that each instance is not an isolated accident. It will happen again and again and again. Further, these minor insults are linked to vast social harms…”

There’s a lot written about microagressions, and I’m just getting started thinking and writing about them. Next year I’m applying for funding to do some focus groups of fatter people to ask about their experiences with health-concern trolling in healthcare contexts. The goal is to find out what they think good health care looks like from their perspective. Stay tuned for more updates on the health concern trolling front.

Readers, what does good health care look like to you? What would you want to change in your encounters with health workers? I’d love to hear from you.

cycling · fitness · Weekends with Womack

The importance of a push: getting by with a little help from our friends (and competitors)

I just stumbled on an article about professional cyclist Kathryn Bertine. In addition to being a multi-sport elite athlete, she’s also written about her experiences in several books.

Kathryn tells a story about a cycling race in which she was in a sole break—she had ridden ahead of the peloton of cyclists and was riding into the wind, which is exhausting. She started to tire:

So I started to fade and fade and fade. And I was coming back into the grasp of the peloton. And I … was just at the end of my rope physically.

What often happens after breaking away from the group in a race is that you get sucked back up into the peloton, but you’re so tired that you may not be able to maintain the speed of the group. Then you get left behind, or “spit out the back” (isn’t cycling terminology lovely?). Kathryn puts it this way:

It’s all been sapped from you, so you are just kind of on this trajectory backward, and everybody else is moving forward. And you just kind of want to scream out, “No, wait for me!”

But then Kathryn felt a hand on her back:

And as I am kind of sailing back through the peloton, almost about to be spit out the back — and that would be the end of my day — I felt this hand on my back and in cycling that is regarded as a push. I couldn’t imagine who this could be. Who would be helping me in this manner?

One of her competitors was giving her a helping hand, a push.


The hand belonged to a rider named Evelyn García, who is on the El Salvador national team. She probably weighs about 50 pounds less than me. She’s this tiny, tiny rider. Sometimes a second or two is all you need in cycling. And it saved me. I think physically I was able to stay in the peloton but also emotionally, too. Kind of someone saying, “Hey, I recognize what you’ve done and I’ve got your back.”

I love this story, not because it is an extraordinary one, and not because I think that helping your competitor is always required. But it’s a great reminder that everyone can use a push sometime, and everyone can offer a push sometime.

I did a cycling road race in Rhode Island about 9 years ago, where the women’s field was open– that means all categories of female cyclists were in my race.  What this also means is that the least experienced racers (Cat 4 in my case) got dropped like rocks in the first quarter mile (of an 18-mile race).  So there I was, slogging my solitary way down the road, trying to keep the next woman ahead of me in my sights.

All of a sudden I heard a whooshing sound– the men’s Pro/1/2 field (which was doing multiple laps of the course and started ahead of us) came up.  They swarmed around me and I was caught up in the peloton.  It is against the rules to mix in with another field during a race, but there wasn’t room for me to stay out of their way, and the sheer physics of the situation took over.  I turned to the rider next to me and said I couldn’t get out of the way, that I had been dropped from my field, so I wasn’t a contender in my race.  He smiled, put his hand very lightly on my back, and said, “oh, it’s fine.  Just tuck in and enjoy the ride.”

And I did.  It was exhilarating– I was riding at least 24 miles an hour and barely had to pedal at all.  My magic carpet ride lasted less than a minute, and then the road kicked up a bit.  The peloton glided past me, headed down the road.

That feeling stayed with me throughout the race, and I can still remember how great it was to be a part of it.  I’ve had similar feelings on group rides, both as the helper and helpee.

Social connections are important in any physical activity. Understanding their nuances, learning how to be a good and responsible participant, discovering new roles to play over time as abilities and interests shift— all of these things enrich my experiences of doing sports and physical activities.

Each sport or activity also has its own rules (explicit and implicit), and as we begin new ones, there’s a lot to learn about them. I’m starting scuba instruction next month.  I blogged about my first experience with it here and am looking forward to learning not just how the equipment works (obviously rather important) but also how to dive with others in safe and fun ways—as a beginner, and when I have more experience under my (weight) belt.

I’m also restarting bike training this winter, and as a push for myself I signed up for PWA’s Friends for Life Bike Rally. I got a little push from Samantha by inviting me and others to join, so thanks, Sam! I officially joined a team that includes a bunch of the Fit is a Feminist Issue bloggers and friends. And I’m sure I’ll need some pushes—both physical and mental—during that long ride. We’ll see what I can offer in the way of pushes for others. One thing I can guarantee—you can get on my wheel on the downhills…

Screen Shot 2016-01-16 at 3.15.41 PM

fitness · Weekends with Womack

Fat flying: the holiday air travel edition

Let’s face it: 21st century air travel ranges from mildly unpleasant to horrific on a biblical scale. As a person raised on the Jetsons, I fail to understand how we have been reduced to being herded like cattle from Pittsburgh to San Diego, Sydney to Melbourne, London to Hamburg, Ottowa to Vancouver. Seriously, I thought we were promised jetpacks by now. As it is, we don’t even get free snacks on board anymore, much less this:


Of course, in those days air travel was long, risky, expensive and available only to the privileged, as we can see in the photo above.

Why is airline travel no longer glamorous or exciting, but instead tedious at best and infuriating at worst? Part of the problem is this: there’s less and less room allotted per passenger on planes. Below is a table from a UK article that includes both pitch (how far seats recline—higher numbers are better) and seat width in inches.


So what do we see? Lots of seats that are less than 18 inches wide with less legroom. That is a reduction of at least 1.5 inches over the last two decades. The shrinkage of seats along with airline practices of cramming as many seats as possible in an already-small space makes everyone more territorial about the itty-bitty amount of personal space they have. This does not make for a congenial atmosphere. Of course you could spend $18,000 USD for this on Etihad airlines:


But that’s not an option for almost all of us.

For people who are larger-sized, flying can be a huge hassle, filled with uncertainty and disapproval, judgment and embarrassment. Why uncertainty? Well, here are some things fat fliers need to know:

1) What aircraft will I be flying? (e.g. Boeing 737, Airbus 320)

2) How wide are the seats on that plane?

3) Will I/how will I fit in those seats?

4) What are the policies for the airline I’m flying regarding seating of larger-sized passengers?

5) What is that airline’s record for implementing those policies? Are they feasible? Are they always/usually/occasionally/never enforced?

6) So what’s a fat flier to do? I can’t drive to Germany!

Let’s look at each of these.

For 1) and 2), you can go to to look up seat maps and aircraft assigned to particular flights. It will give you seat width and pitch for legroom. However, this isn’t guaranteed, as aircraft get substituted for maintenance and scheduling reasons. So you might get stuck with some other plane with a less feasible seat configuration.

For 3), the answer is: there’s not a way to tell ahead of time whether you will fit in the seat on your flight. Numerous bloggers and commenters about this topic have made the following completely reasonable suggestion: airlines have standards for carry on bags, so they have something like this for you to check to see if your bag fits.


However, airports don’t have sample seats for people to try out before they proceed to the gate. And, since seats vary in width and pitch, this would be hard to do. Of course a natural suggestion would be, “how about we standardize this, eliminating that uncertainty?” Airlines don’t agree, as they are constantly looking for ways to squeeze more passengers into aircraft. In fact, this “saddle” seat has been proposed for some short (less than 3 hours) flights for ultra-dense packing.


No comment.

For 4), the airlines have policies posted on their websites, and on this site the information is collected for many airlines (it’s only current to January 2015, though). Most airlines say that customers must a) fit in the seat with the armrests fully down; b) be able to fasten the seatbelt, with extender if need be; and c) not “significantly encroach on the adjacent seating space”.

Of course, because of the problems with 1) and 2), you may not know whether you meet these criteria.

But for those who think they might not, the general policy is for those customers to purchase another seat. For the record, the consensus is that Southwest has the best policies (found here ) for what they call “customers of size”. You buy an extra ticket in advance (and there are instructions for how to do this online—it’s trickier than it sounds). Then, after the flight, you can request a refund for the extra seat you bought (this is also trickier than it sounds, but people have reported that it does work). Other airlines are less clear and less forthright about refunds, but knowledge is power, so looking it up ahead of time is a good thing.

For 5): Sigh. On all sorts of blogs about this issue, people report that airline employees commonly break every rule in the policies—they will seat people when the armrests don’t go all the way down, they will try to seat passengers in the extra seat purchased by a larger person, and if any discussions get confrontational, the squawking customers get escorted off the plane and maybe arrested. This causes uncertainty, embarrassment, anger, and major discomfort for everyone involved. This seems in large part avoidable through better training of airline employees, better information offered to passengers of all sizes. And, (call me a cockeyed optimist, but) if businesses promoted an atmosphere of professional courtesy and civility, maybe more people would follow their model. I know, I know. But a girl can dream, can’t she?

For 6), Ragen Chastain of the great Dances with Fat blog offers a bunch of suggestions for airlines to follow. They are very clever and creative (you can read them here), and include ideas like making seats of different widths and charging more for them. Another is letting passengers check a box if they don’t mind sitting next to a larger person, with possibly a small rebate. The nice thing about her suggestions is that they also solve the problem of tall or big people whose shoulders are wide—they don’t just focus on hips and waist measurements.

So even though one seat size doesn’t fit all, there should be some better ways to carry us all to our destinations with a modicum of comfort and dignity.  It’s time for the airlines to put together some humane, feasible, simple and comprehensive policies about transporting people of different sizes and shapes home to Grandma’s house or wherever they are going.  And then to train their employees to follow them.  And also to inform ALL their customers so they can fly with fewer worries.

Although I’m still waiting for those jetpacks.


accessibility · feminism · fitness · swimming · Weekends with Womack

Swimming with no men– McIver’s Baths and single-sex spaces

Since I’ve been in Sydney on sabbatical, I’ve had the chance to go to a few of the incredibly beautiful rock tidal pools here that are built on the ocean in a protected area for swimming. One of the most famous, Wylie’s Baths caters to serious swimmers, people with kids, and anyone who wants to enjoy sun, surf and sea in a pool where the waves wash over you. Here is a picture from my visit there.

Screen Shot 2015-12-06 at 11.02.27 PM

Right next to Wyle’s baths, in Coogee beach in Sydney, is another pool—McIver’s Baths. What makes McIver’s Baths special is that it is a women-only space (young male children are allowed, as well as female children of any age).

McIver’s is also special in that it has been a women-only bathing space for well over 100 years. It is reputed to have been a historical location where Aboriginal women bathed, and was formally constructed with changing rooms in 1886. The McIver family took over running it until it was taken over by the Randwick Ladies Amateur Swimming Club, which has held the lease on the place ever since.

Screen Shot 2015-12-06 at 11.06.03 PM

There have been objections to the exclusion of males from the pool throughout the history of McIver’s. Most recently, in 1995, a man complained to the New South Wales Anti-Discrimination Board that he was barred from the baths on account of his sex. The city council responded that there had been no complaints of this nature, and the lessee stated that they couldn’t afford to build changing rooms for men. (It is also true that Wylie’s baths, which admits everyone, is 450 meters away).

A blogger writing about the history of McIver’s added this about the case:

The women’s pool was traditionally used by older women, women with disabilities, nuns and others who preferred privacy as well as pregnant women and older people with arthritis who enjoyed the pool’s private sunbaking area and didn’t want to go to the beach, indulge in mixed bathing, or be bothered by men. Thursday was traditionally married ladies day. Girls’ schools held water safety classes at the baths, which were popular amongst the Islamic community. The club’s free lessons had helped Islamic women and children gain confidence in the water and some Islamic women contended that it was the only place their faith permitted them to swim. The medical profession argued that Coogee’s women’s baths were the only place where women who had suffered disfiguring operations could comfortably bathe.

As I was going in on Saturday I saw some Muslim women in hijabs and tunics, with their full-length swimsuits underneath. They were leaving the bath, carrying inflatable pool toys with their kids in tow. As I changed I saw women of all ages, sizes, and nationalities hanging out on the rocks (some sunbathing topless, some reading), swimming, wading at the edge, and chatting with other women. A bunch of the women were swimming topless, some in their underwear—as if they had decided impulsively to stop by for a swim, but hadn’t brought a bathing suit with them. No suit? No problem! Others (like me), were in bathing suits, long-sleeve rash guard shirts, with goggles and cap, doing laps.

Now, I’ve spent a lot of time in women-only activities—I play on a women’s squash team, I’ve road and mountain bike raced in women’s fields and I’ve taken a zillion dance classes that were almost entirely women. And I’ve enjoyed the feeling of camaraderie you get in a women’s locker room. Tracy has blogged eloquently about that experience here .

But I really really like this space. I like the friendly vibe, the feelings of safety and relaxation that other women told me they felt here, and the freedom to swim or read or sunbathe unfettered by suits or judgment. In particular, I saw several larger women swimming, hanging out, smiling, and walking around with none of the self-consciousness that I’ve witnessed (in myself and others) countless times at public pools, gyms, and beaches. This is not to say that women are uniformly non-judgmental, but rather than this place—a place for women-only—seems to dictate a congeniality and solidarity in attitude which I wish existed at every swimming pool on the planet. Tracy has blogged here about women-only races and offered some responses to those who think they are unjustly exclusionary.

If readers have qualms about dedicated women-only spaces, let me know—I’d like to hear them. I’ve not offered any arguments here, just said that my experiences and observations were overwhelmingly positive.  But if you’re ever in Sydney you should go. Among other reasons, the entrance fee is only 20 cents!

Screen Shot 2015-12-06 at 11.11.18 PM


fitness · Weekends with Womack

In praise of feet as travel accessory

imageTraveling, for me, is energizing, refreshing and a real pleasure. It’s a chance to leave my regular life for a bit and try on different modes of existence. Eating new foods, embracing a new cadence for the day, looking at other landscapes and diving into another environment are all ways to clear out old habits and experiment with new ones.

When I lived in Italy 16 years ago I tried dressing up more in response to the well put together Italians I encountered every day going about their business. Sadly, that habit didn’t really stick. But I did develop a love for Italian coffee that has persisted.

Another thing that travel does for me is remind me of the virtues of public transportation. In Boston I drive and ride my commuter bike around town but don’t usually take subway or buses much. In other places– especially cities with good public transportation infrastructure– it’s easy to get around on trams, trains, buses and even ferries. It may seem like it’s more time consuming (and does require some planning), but it’s a great way to see what a place is like. You can get a look at the locals in their daily lives and also see the working areas– not just the tourist sites.

Engaging down the path to discovery is sometimes taxing, though. Managing the logistics, luggage and lag (of the jet variety) sometimes leaves me a bit low energy. But I’ve noticed something else on my travels for the past two months: no matter how tired, lost, confused or homesick I’ve been, walking around always makes it better. Here are some examples where walking is a handy option;

I’m in an airport with a long wait, too tired to read. I walk around.’m newly arrived somewhere and majorly jet lagged– headachy and queasy and out of sorts. I walk around (preferably with nice friends like Samantha and Diego, who I saw Tuesday in Toronto).

I’m not feeling up for navigating yet on my bike in a new place. I walk around.

I want to get a feel for a neighborhood, but have no particular destination in mind. I walk around.

I spy a forest path or beach that looks enticing. I walk around.

My normal sports outlets are not available because I’m far away or can’t find or afford to do them. I walk around.

I’m traveling back to Sydney for 3 more weeks of work and exploration and social fun. I’m planning on swimming, kayaking, snorkeling, hiking, and of course riding my bike. But no matter what, my feet are available as a handy travel tool to combat lots of travel woes.

So thank you feet!

Weekends with Womack

Moving through shock, outrage, and sadness

Sometimes terrible things happen, and we have no idea how to comprehend them, much less respond to them, much much less combat them.

Something terrible happened in Paris Friday night—as of this blog writing, at least 125 (reports vary right now) people were killed in armed attacks while at a concert, a sports stadium, a restaurant and other popular spots in the city. The story is still unfolding, and will likely take some time to become clear.

I don’t know what to say here on this blog about the awful massacre. I don’t know what to say here on this blog about the violent world we live in. One thing I do know—when terrible things happen, it’s good to keep movement an important part of our lives. It helps center and calm us, and it is often done in the company of friends or family.

So let’s do some movement today.

To keep us company, here are some pictures of some female athletes, engrossed in the joy and concentration of sports or activity.

Alize Cornet

Alize’ Cornet—professional tennis player, beat Serena Williams 3 times in 2014, including at Wimbledon.


Iranian soccer player (not identified), found on the Muslim women in sports Facebook page.

Marcia Ella-Duncan, member of Yuin Nation of New South WalesMarcia Ella-Duncan, championship netballer and member of Yuin nation in New South Wales, Australia.

Screen Shot 2015-11-14 at 9.14.33 PMMarjorie Turner-Bailey, Canadian track and field champion and Olympian in the 1976 games.

take aimYoung girl at a French camp, learning archery.

I’ll stop here, and will be back next week.

Weekends with Womack

Industry and Nature side by side: urban kayaking in Adelaide

Kayaking is an activity you can enjoy just about anywhere there’s water. Of course you have to pay attention to features like tide, current and wind patterns, the topography of the area, bigger boat traffic, and also any natural predators or dangerous plants or animals. For instance, I went to the beach Saturday at Semaphor Beach in Adelaide, South Australia, with friends, when I encountered this sign:


Snakes? There are SNAKES here at the beach? What am I supposed to do about this?

I was told that snakes can hang out in the dunes, so don’t go walking there. Okay, I guarantee I won’t. And I didn’t. And my beach experience was snake-free. Yay.

Sunday I had a reserved a kayak with Adventure Kayaking SA (South Australia), pretty much the only outfit I could find that rents kayaks at a launch site relatively close to downtown Adelaide. They are great—they rent both kayaks and SUPs, offer instruction and tours, and their staff are knowledgeable and friendly. Here is their facebook page if you’re in the area.

To get to the launch spot I had to drive basically through the Port of Adelaide, which looks like a port area—lots of warehouses, shipping containers and cranes, and other big industrial structures. Then, turning onto Garden Island Road, I saw a large power plant, with this sign:

Screen Shot 2015-11-08 at 9.50.46 PM

“Inlet temperatures may exceed safe swimming limits.” That made me wonder just what the melting point of my kayak is— not information I had previously considered salient, but there you go.

Driving on, I stopped and took this picture of what was behind me.


I was starting to get the feeling that the kayaking place was right next to a nuclear testing site. But on I drove. And I arrived to see a nice-looking park with the kayaks all set up and ready to go. Whew.

The Adventure Kayaking SA folks were able to provide me with everything I needed as a slightly more experienced kayaker. I got a better fitting (more snug, with narrower cockpit) boat, dry bag, better paddle, and no need to spend time on instruction once they determined I knew what I was up to. They just made suggestions on where to go, and helped me launch. And I was off!

There are two big draws to this area for kayakers. One is that you get to kayak in a dolphin sanctuary. You’re not allowed to approach them, but they end up swimming near you anyway—they’re smart and friendly and playful. I took a ton of pictures, but it turns out it’s rather hard to get a good picture of a dolphin 1) with your phone; 2) from your boat; and 3) while the dolphins are above the surface or doing something interesting. This was the best I got, which was actually much closer than it looks here:


On the facebook page for the kayak place, they have a lot better photos. This one was taken with a SUP group that was out when I was there. You can actually see them:


The area where we saw the dolphins is bordered on one side by a mangrove swamp, which looks like this:


If you continue down the inlet, however, you get to this:


Those are barriers across the inlet keeping you from that power plant, I mentioned. Not able to stop myself, I did put my hand in the water, which was warm, but not the temperature implied by the sign. Whew again.   Here’s another shot of the mangroves plus powerlines.


The other draw for boaters in this area is the Ships Graveyard.  In the larger area, about 40 abandoned remains of ships are sunk or partially sunk in shallow waters. I got to paddle right up to a few of them. Here’s a view of one wreck:


You can actually go all the way around it—here it is, in its rusty beauty, from the other side, viewed from the bow of my boat:


Again, we ran into barriers not much further along, as that power plant takes up a lot of space. However, there was enough nature and water to keep me happy for a few hours on a very sunny and hot spring day (33 C/91 F).

Somehow I keep experiencing (and posting about) the urban or industrial outdoors. What’s so great about it? I mean, isn’t it much nicer to find some more pristine natural area like here:


Or here:


Yes, these are gorgeous, travelogue-like images of what being outdoorsy means. Trips like these are great, where you’re far away from life and civilization. But—we don’t always have the time, the money, the access, the organization or logistics to go far away. We do, however, often have the time and access to natural spots near our own backyards.

My kayak instructor Spencer talked to us about the local adventures he sets up for himself and friends. His trips often take place less than 20 miles from where he lives, but involve challenges of elements—wind, tide, temperature, rain, snow, maybe even dark of night—in places he knows very well. I like that idea—it’s a good one to keep in mind when you need a quick or cheap or easy jaunt to sweep out the everyday cobwebs, just in time to return home to dinner.

My next local cheap urban-y outing will be when I return to Sydney in late November. My plans are to swim in as many of their tidal sea baths in the area as I possibly can. Some of them are here and they are beautiful. I doubt I’ll get to all 44 listed here but will report back on my progress. In the meantime, readers, where have you gone close to home that gave you nature plus urban/industry experiences?

Weekends with Womack

“Obese” is a bad word—it’s got to go

(Hi folks– sorry for the late Weekends with Womack post; technical difficulties down under.  Thanks for your patience.  Now to the post…)

We use a lot of words to describe large (or large-ish) bodies:

For instance: fat, plump, hefty, bulky, rotund, pudgy, chunky, portly, heavyset, stout—I found 46 synonyms here. Roly-poly may be my favorite one.

Here’s one I don’t think we should use anymore:


Why not? In some ways, “obese” seems less pejorative and less judge-y than those other words. In fact, it’s really just a clinical word, with a precise definition; nothing to be upset about. Most adults with a BMI of 30 or higher are considered obese by medical definition. It’s also easy to determine when it applies. I can weigh myself, measure my height, consult my handy BMI chart (like the one below) and determine reasonably accurately my BMI.


So why do I think it’s a bad word? Two types of reasons, one scientific and one ethical.

The scientific reasons to get rid of “obese/obesity”: the term “obesity” applies to anyone with a BMI of 30 or higher. But why does medicine and public health use this term? The main idea is that if you are obese, you are in a medically deficient state that needs addressing. In particular, you are at increased risk of developing type 2 diabetes, heart disease, some cancers, orthopedic problems, sleep apnea, and some reproductive problems, among other things. Some of these conditions are potentially life-threatening, so losing weight and becoming non-obese is a compelling health goal. That’s the story.

But is it true? No, not as stated above. Not all BMI numbers 30 and above are created equal. In a widely-cited 2013 study, Katherine Flegal and her co-authors found that people with BMIs 30—35 did not have a higher risk of death than people with BMIs in the 18.5—24 range (called the normal range). Higher risks of death were documented in BMI ranges above 35. And lower risks of death were documented for those in the “overweight” range—25—29.

This news was not taken well; medical and public health professionals unleashed vitriolic criticisms. A Nature article on the topic discussed the problem here:

The result seemed to counter decades of advice to avoid even modest weight gain, provoking coverage in most major news outlets — and a hostile backlash from some public-health experts. “This study is really a pile of rubbish, and no one should waste their time reading it,” said Walter Willett, a leading nutrition and epidemiology researcher at the Harvard school, in a radio interview. Willett later organized the Harvard symposium — where speakers lined up to critique Flegal’s study — to counteract that coverage and highlight what he and his colleagues saw as problems with the paper. “The Flegal paper was so flawed, so misleading, and so confusing to so many people, we thought it really would be important to dig down more deeply,” Willett says.

But in fact Flegal’s results have been duplicated and even extended to show that “obesity” just isn’t a useful word to refer to a medical condition. In this article, Ann Barnes cites US data that shows that weight affects life expectancy differently in white women and black women—for black women, weight isn’t a risk factor until a BMI of 40 is reached, vs. a BMI of 30 for white women.

There is a lot more data out there showing that what we call “obesity” is not one category at all—it is a range of different categories that apply differently to groups depending on age, race, ethnicity, gender, income, geographic location, etc. One size-name simply doesn’t fit all.

There’s more to say about this (there’s always more to say…) but I’ll now turn to the ethical reasons not to use the terms “obese” or “obesity”. My friend Stacy co-wrote this fantastic article about the socio-political meanings that have been attached to the term “obesity”, and I quote from their article below:

In this… social and political sense, obesity is associated with powerful negatives, stemming from both long-standing prejudice and recent public health framing. These include epidemic threat, devastating impending costs, tragedy (particularly children routinely dying before their parents), as well as poor character in obese individuals, who are frequently implied to be lazy, to lack willpower, to be greedy, or to shirk personal responsibility. This view is used to legitimize the well-documented discrimination experienced by heavier people, especially women, particularly younger women and girls. For people above normal weight, then, public discussion of obesity is fraught.

Obesity in the sociopolitical sense also became institutionalized fairly rapidly in universities and governments in the late 20th century. There are now obesity strategies, government departments responsible for obesity, obesity handbooks, professorial chairs, university research centers, websites, Twitter feeds, and advocacy groups with the word obesity in their titles. So obesity as an amorphous but potent social and political concept now raises the stakes in many settings, engendering blame, inducing strong feelings, and providing the focus for many people’s professional roles and identities.

In short, shouting “obesity” in a crowded doctor’s office raises alarms, brings on waves of shame, provokes stern and dire warnings, and puts everyone on notice: Something. Must. Be. Done. Now.  But maybe nothing needs to be done.  Or maybe something does need to be done, but what that is will vary a lot, depending on a bunch of complex factors.  It’s not a uniform call to lose weight, come what may.

I know, we can’t solve these problems just by getting rid of the words. But getting rid of them would be a step towards acknowledging that the story about weight, health, and illness is a very complex one, and using “obese/obesity” confuses us, misleads us, shames us and blames us. So let’s get rid of it. When we need to talk about people’s weight, there are lots of other words around—let’s use them instead.

Weekends with Womack

Getting fitter in Sydney—my public transportation training plan

It’s now been 3 weeks since I arrived in Sydney for my sabbatical work trip, and I’ve been blogging a lot about the changes it’s brought about in my physical activity and other health-related habits. At first it was a big adjustment to carry around my laptop, work stuff, and haul groceries from the store to my apartment, all on foot. Sydney is also hilly, so hauling myself up and down those hills was causing knee pain and considerable huffing, puffing, and sweating. Even though I thought I was fairly active in Boston, I really noticed a difference in how my body felt (namely more achy and tired in my shoulders and feet), how I slept (longer than I do at home) and how I ate (generally less than at home).

I’ve also been going places using public transport. The public transportation system here is pretty extensive, with buses, light rail, heavy rail, and ferries (I get on a boat to go to Sydney Opera House from my apartment!). Today I took bus and light rail to get to the beach at Maroubra where I met some friends for a beach outing and fish and chips after (Sydney has completely mastered the art of frying, I must say). I’ve been taking buses all over town, walking to lunch dates, and riding my bike along the multi-use paths and some quiet streets.

I’m starting to notice some subtle differences. My right knee is not really hurting going down stairs or hills, and my left knee is not really hurting going up them. This is a good thing. The hills on my regular routes just don’t seem as long or as high as when I first got here. The bags I carry don’t seem as heavy. Could I be getting fitter?

The evidence is promising. A recent Wall Street Journal article  tells stories and quotes studies about the benefits of walking, biking and taking public transportation to and from work. In some studies done both in the UK and the US, researchers found that commuters switching from driving to taking public transport experienced on average some small weight loss over time. This is not surprising, given that (according to this study) commuters using public transport average an extra 8—33 minutes of day of walking.

I’m not advocating public transport as a weight loss tool; what I’m saying is that, after 3 weeks of walking, busing, cycling, and taking trains and ferries, I’m feeling peppier, more nimble, stronger, and in general better.

And that’s not all that public transportation does for us.  According to many reports on the benefits of public transportation on health. It’s basically good for what ails you, especially if you prefer fewer traffic accidents, cleaner air, less car-induced stress and congestion, and a more active approach to getting back and forth.

I plan to keep up the active commuting when I return to Boston. It will take some prioritizing, as it’s not simply a 20-minute walk like what I have here. I will have to take the bus or ride my bike to the subway, then take the commuter rail to my academic job at home. This takes a long time—1:45 each way! But the drive is about an hour each way (sometimes more if traffic is bad), and it is a misery. I’m really tired of doing it, so next semester, I will take public transport at least once a week and see how things go from there. The fact is, I like it—it feels good. So why not do it?

What about you, blog readers? Have you changed your commuting habits lately (or not)? Have you noticed any changes in how you feel? I’d love to hear about it.

Weekends with Womack

First thoughts on cycling down under, over there on the left side of the road

Some of you blog readers may know that I’m spending a few months in Australia while on sabbatical from my academic job in the Boston area. And of course I brought my road bike with me. But I just started riding this weekend, about 2 weeks after I arrived. Part of the delay was that I was recovering from jet lag and then getting oriented at work (I’m visiting at the University of Sydney, and gave a talk on Thursday).

But really, the reason why I hadn’t started cycling was fear. I was terrified at switching to riding on the left side of the road. Okay, I feel a little better now that’s out there.

In my partial defense, just about everyone I talked to in Sydney thought that cycling in the city was dangerous. Of course people in Boston think the same thing, and they’re not completely wrong. And I don’t let that stop me from riding all over the place at home.

More defense claims: I haven’t seen many bike commuters around in my part of Sydney (inner west for you Aussies). Nor have I seen many in the downtown area, either—not on the main roads anyhow. So I was thinking, hmmm— maybe they know something I don’t.

But then there was my bike, sitting in my landlord’s garage, all alone in a new country, not getting any attention from me. That’s just wrong. I owe it to myself and the bike to get out there and develop some new skills and have some new adventures. Right? Uh, ok.

So I did just that this weekend.

Part of my motivation was a combination of necessity and laziness. I had brought a hand pump with me (a floor pump was too heavy to transport), but forgot the connector hose (oops). So I needed to get a new pump and some CO2 for keeping my tires in shape. The nearest bike shop was only a 12-minute ride (according to google), but a 40-minute bus trip. Clearly I’m getting on the bike.

So I made my way to the shop, going up and down (Sydney is hillier than I had expected), making right and left turns, which are reversed in order of difficulty. And I didn’t even end up on the wrong side of the road while turning. Yay! Whew…

Having obtained my new pump and some cartridges for my inflator (and basking in the glow of praise for my bike from the shop guys—love when that happens!), I headed back out there to explore a little. I found some lovely mixed-use paths by the water and rode around. There were a bunch of cyclists, including road cyclists—finally I found some of my people! Sydney is so beautiful, with water everywhere you look, and I enjoying winding my way around, taking some quiet side streets and paths.  Here’s a shot from near the water. IMG_5322

Here’s another one.

IMG_5318Who wouldn’t want to see that all the time?

My next step is to do some proper road rides. Samantha has been very nice and given me some contacts, and I’ll be talking with them and others about getting out on the road at speed. But one revolution at a time….

In the meantime, here are a few parting observations I made based on this weekend’s experience:

  1. Traffic is traffic, and many commuter cycling traffic skills translate nicely.

Riding on a busy city street, I encountered buses, cars passing me (on the right), pedestrians popping out everywhere—business as usual on a bike. I found that paying attention worked the same way. Of course this is unsurprising, but I was really gratified, and it helped build confidence.

  1. Old instincts die hard when encountering other cyclists.

Riding on a mixed-use path around Sydney, I saw a guy on a lovely vintage Bianchi coming toward me around a narrow corner. I immediately swerved a bit to right. Of course, so did he. Oops! Actually, this was what I said out loud, followed by “sorry about that”.   We were going slowly, so all was well, but it reminded me to be more aware, as my instincts were not always going to lead me in the correct direction (quite literally).

  1. Cycling totally rocks, no matter where you are.

Getting back on the bike really made Sydney feel more like home. I’ve got my mode of transportation, I’ve got another way to meet people and make new friends, and I’ve got a passport to new adventures. Yes, that’s a little cheesy, but when it comes to me and my bike, I’m a sentimental soul. And I’m really glad it’s here with me.