body image · boxing · fitness · weight stigma

The world is changing its perception of larger active bodies but not Garmin

So it turns out, according to Garmin, that my fitness age is 74. My fitness is poor and I’m in the bottom 5 percent for my age bracket.

Colour me shocked.

I thought it was because of inactivity due to knee replacement surgery. Garmin doesn’t track my weightlifting or my physio so all it knows are my steps per day, heart rate, rest, and numbers of kilometers ridden. And yes, it’s true I’m just riding 50 km a week on the trainer right now. That’s down from my usual 100 or 150. My step goal is in the 5000-6000 range and I meet it most days but that’s down since I had knees that worked.

Still it seemed wrong. I wouldn’t think that someone who rode their bike 50 km each week and walked more than 5000 steps each day would be in the bottom 5%. My resting heart rate is in the low 60s and that’s pretty good too.

It’s true I’m not my usual fitness self but bottom 5%?

So I googled how Garmin calculates fitness age and I remembered one more piece of information Garmin has, my weight.

Argh. Argh. I should have guessed. I should remembered Nicole’s blog post about this. And in her case there was only a two year gap. The gap between my actual and Garmin’s fitness age for me is 16 years.

Good gravy.

Bundling weight into the definition of fitness doesn’t even make sense to me. You can no longer ask about the relationship between fatness and fitness because on this way of measuring fitness, the weigh scale is built in.

I was embarrassed at first to blog about this. I shut off the Garmin app and stormed around the house a bit. I did some chores in a loud grumpy fashion. But the more I thought about it the more I realized it’s their problem, not mine. I’m going to write and ask them about. I’ll let you know if I hear anything back.

Not me but a woman with pink boxing gloves who kind of looks like I feel.
fitness · weight stigma

For the nth time, fitness doesn’t equal weight: Lizelle Lee and the meanness of fat phobia in women’s sports

CW: Discussion of judgments about body weight, negative self image talk, and weight discrimination in women’s sports.

South African Lizelle Lee is the world’s leading women’s cricketer this year. She was also awarded best women’s one-day international cricketer in 2021. If you know about cricket and want to see her stats, they’re right here.

Lee announced her retirement from international cricket before the start of a series with England that she was scheduled to play in. Why? Because some officials deemed her too fat to play.

What?! Yes, it’s true. Here is a list of the main facts:

  • Lizelle Lee is one of the world’s top women competitors in cricket.
  • Lee trains and attends gym sessions. She recently passed the run fitness test.
  • Her team has weight requirements, which they claim are part of the “fitness” requirement. Lee did not meet their weight preference thresholds.
  • In order for Lee to be able to continue to earn money as a professional athlete, playing cricket domestically, she would have to resign from the international team. For the details, check out this article and this article.
  • So, Lizelle Lee retired (at age 30) from international cricket.

By the way, three days after she was forced into resigning, her team “lost three ODIs and three T20 matches against England, suffering an overall 14-2 defeat on points in the multi-format series.”

This story makes me really angry, because it is one of so many examples of how mean and destructive and irrational fat phobia is in women’s sports.

It’s mean because Lizelle Lee, who is a titan in her field, one of the world’s top athletes, is barred from play and made to feel like her body is to blame. This is the same body that plays cricket the way almost no one else can. Here’s Lizelle Lee below:

Here’s another content warning: Lee speaks about her negative body image, which is certainly in no small part due to team officials preferences that her body be smaller.

“I know I don’t look like an athlete but that doesn’t mean I can’t do my job,” Lee told the BBC World Service’s Stumped podcast. “I looked like this last year and I had a brilliant year.

“I don’t feel good about myself. I don’t even look at myself in the mirror any more because I don’t like the way I look. But that comes along because every time I’m in (South Africa) camp, it’s always about my weight. Emotionally, it breaks a person down.”

This breaks my heart. And then I get livid. I don’t play cricket, but she looks like the very model of an elite athlete- powerful, confident, graceful and focused.

Let’s be clear: Lizelle Lee is more than fit to play cricket internationally. She’s proved this through her record. So this isn’t about her ability to play. It’s about what her body looks like. Lee explains more about this in a BBC interview excerpted below:

“The big thing that got me is that I made the fitness physically. I did the running that I had to do. Basically, I’m fit to play,” she said in the interview. “I had this conversation with them in Ireland – because I got dropped in Ireland because of my weight as well – and I told them ‘you’re dropping me because of the way I look and how much I weigh’ and they said ‘no, we’re dropping you because you failed the fitness battery’.”

“I said: ‘Yes, okay, but if you break the fitness battery down, what did I not make? I made the fitness, the running, but I didn’t make my weight. So, you’re dropping me because of weight’.”

Yes, that’s exactly what they are doing.

Forcing Lee to retire is also destructive. First, she had to retire in order to continue to have a job playing cricket, which is what she does to pay the bills.

Had Lee not retired and potentially not received an NOC (no-objection certificate, saying it’s fine for her to play), she would not have been able to play in domestic leagues around the world and subsequently not have received a large chunk of her annual income.

“Probably one of the reasons I had to decide to retire is to make sure we don’t have that [debt] anymore. The salary from The Hundred is a little bit more than my yearly salary at CSA, not counting match fees and World Cup prize money,” she said.

Also, Lee’s team suffered from her absence. They lost their first match without her. Surely forcing Lee out will hurt team morale.

Now to irrationality: team officials’ claims that Lee failed her fitness test because of her weight are completely irrational. Lee has shown that her weight is not a detriment to her fitness. Far from it– she passed all the fitness tests. When asked about what role weight played in calculating fitness parameters for athletes, team doctor Shuaib Manjra said this:

“The fitness test is not based purely on weight; it’s based on a number of parameters. You need to meet a very low threshold of 60% to pass the test. You have a composite score of different parameters, weight is one of them.”

The one test you must pass is the 2km time trial, not the weight. If you pass the 2km time trial and the other tests then you’re fine, but weight is not the sole criteria. It’s a composite score set at a low level of 60% which you need to pass in order to be eligible for selection,” he said.

This makes no sense at all. Lee passed the 2km time trial and other tests. She simply didn’t meet their weight preferences. Furthermore, Lee points out that another player failed the fitness test (but presumably not the weight preference test) the following week, but was not threatened with withdrawal of her NOC (the no-objection certificated required for play).

Fat phobia is mean, it’s destructive, and it’s irrational. And it’s rife in women’s sports. Just ask Serena Williams. Or Michelle Carter, Olympic gold-medalist shot putter. Or me. Or many of you. Let’s keep calling it out. Maybe some day, with all our efforts, we’ll hit it out of the park.

Woman about to hit a softball. It's teed up and ready to go sailing out of the park.
Oh yeah– tee it up and we’ll knock it into oblivion.
fitness · weight loss · weight stigma

When bias guides research

Content warning: discussion of weight loss, weight loss methods

Researchers at the University of Otago in New Zealand announced on June 28 they had developed a new world first: a magnetic lock that effectively wires a jaw shut leaving users to rely on a liquid diet so they can kickstart weightloss.

You can read all about it here on this Twitter thread, the university’s website, and the journal which published their results. The researchers say their goal to provide a tool to address the global obesity epidemic.

Rapid weight loss causes physical harm. There’s a reason wiring jaws shut fell out of practice, the outcomes weren’t great, and included long term dental and mental health issues. While there has also been an uptick in surgical interventions (gastric bands, sleeves etc), there have also been post operative issues to manage as well.

The Twitterati have been vocal, with multiple comparisons to chastity belts, racks, and other medieval implements of torture. Others have highlighted the ethical, social and medical issues such research seems to have overlooked.

The researchers recruited seven healthy (oh the irony) obese females. Six completed the study (one left for reasons unrelated to the study). All of the participants regained some weight (about .73 kg average) in the first two weeks after the device was removed. Information about their weight status six months or a year after the study was completed was not included in the journal article.

The study met the university’s requirements for ethics approval. Despite the limited number of participants and the short time frame of the study (two weeks), the researchers felt comfortable enough with the results to propose expanding their research to include a gender balance. As well, they proceeded to modify their device (make it smaller, less obvious etc) to improve acceptability and tolerance.

The study raises significant red flags. Other studies with low numbers of research subjects (can I remind you of the infamous Lancet study on vaccines and autism?) have contributed to significant negative impacts on public health. The study does not disclose any conflicts of interest, but we do not learn who owns the patent on the device or how much they plan to sell it for.

The supports provided the six participants are also not usually those provided routinely to other obese individuals who are told to lose weight. The authors said participants had access to a dietitian, were supplied with liquid meal replacements, and had access to dental care and medical supervision. Obese individuals often have to pay for similar services/options.

I suppose I should be cheered by the fact that so many people have come out against this news. However, the fact that someone thought this was a good idea in the first place and it received ethical approval is quite disturbing. The authors recommend repeated cycles to aid momentum. I think this suggests a devolution into disordered eating with frequent gain/loss cycles.

I sincerely hope this device is investigated not as a welcome medical intervention but as a dangerous tool. There has been ample work looking at the roots of obesity and the kinds of supports needed to support individuals in nourishing their bodies appropriately, beginning with the social determinants of health. There is nothing new or innovative about this technique as it is merely a less permanent form of jaw wiring. It is, however, an excellent way to promote weight stigma, eating disorders and increased physical, mental and oral health issues in otherwise healthy people.

fitness · weight stigma

What some twenty-somethings think about the “headless fatty”

CW: Talk about the “headless fatty”, discussion of fat stigma and weight discrimination.

Like all reasonable decent people, we at Fit is a Feminist Issue despise those “headless fatty” photos. Samantha and I have blogged about them, and others of us have noted and criticized those discriminatory images as well.

No more headless fatties…

Why the headless fatty photo has got to go…

Fat babies deserve heads

Wow, not even chubby babies get heads these days…

Like a bad penny, these awful images keep turning up.

I’m teaching a course on Philosophy of Food in summer school right now, and we are starting it by talking about food memories, preferences, traditions, rules, violations of rules, and ideals. One of the questions I asked them in a short response paper was about the notion of the “headless fatty” and what they thought about it. Here’s some of what they said:

… the “headless fatty” is problematic because in these pictures the bodies become symbolic. These people are in the photos, but they have no voice, not even a mouth, brain, head, no thoughts or opinions. They are reduced and dehumanized as symbols of cultural fear. The beheaded people in these photographs also symbolize that they are being punished for existing, or they no longer have the right to speak, and that without these people the world would be a better place. 

Yeah. I definitely couldn’t have said it better myself.

Here’s another comment:

[the headless fatty] perpetuates the idea that fat people are not people; that they do not have a brain, a voice, or opinions.

One more, which I really like:

This term is problematic because when you remove someone’s head, they no longer have thoughts or opinions.

YES! It’s so clear to my students that the image of a fat person with no head conveys the idea that they have no agency, no humanity, no intelligence, no voice.

I’m writing this to you because these students are giving me hope that fat shaming and weight stigmatization will dissipate; it’s obvious to them that these images are fat shaming, and also obvious how horrible and harmful that is. Yay students!

Let’s all look forward to a time in the not-distant future where people of all sizes and shapes can hold their heads up high, in part because they have heads. Is this too much to hope for?

Readers, how long has it been since you saw one of these headless fat-shaming images? Yesterday? Last month? Last year? Let us know. I’m really hoping they’re on the wane.

fitness · weight stigma

Anti-fat-shaming videos: don’t do more harm than good, folks!

CW: Inclusion of an video that depicts a scene of fat shaming and purports to be anti-fat-shaming, but in fact is fat-shaming. Discussion of body weight, eating, fat-shaming. Mention of the “Karen” phenomenon. Mention of an ableist term and its use.

There’s a new anti-fat-shaming video out there, and it’s very sincere in its attempts to alert people to fat-shaming and to explain why fat-shaming is wrong. Here it is (again, note content warnings above):

The initial scene plays out roughly as follows: A fat woman walks up to the counter of a coffeeshop, orders a kale salad and a small chai tea latte. The cashier– a thin woman– calls her “Fatty” instead of her name, Patty. She also interrogates her about the order in ways designed to fat-shame her. When Patty receives her latte, the name written on the cup is “Fatty”. She runs out of the shop.

Customers in the shop look silently on the scene, no one speaking out, until one man comes up to the cashier. He gives a sincere soliloquy about how the cashier– called, yes, Karen– shouldn’t have bullied Patty.

Here’s where things go wrong:

  1. He defends Patty’s right not to be bullied, saying she deserves respect and is trying to change. Change what? Her body size, one assumes. Argh.

2. Then he cites her food choice of a kale salad and small almond milk chai latte as evidence of her desire to change. No, dude. You shouldn’t have gone there.

3. He compares Patty’s state of self to being sick in a hospital, indicating that none of those groups deserve shaming. This is getting really bad really fast.

4. He does go on to connect fat-shaming to stress-eating and point out that studies show that weight discrimination doesn’t “motivate change”. Sigh. This is a more subtle error, but error nonetheless. He’s fully on board with the idea that fat people suffer from fatness and need to be motivated or helped to change. This belief is at the heart of fat-shaming.

5. He uses a ableist word, “lame”, to criticize some views about body image. Gotta be more careful, dude. You don’t want to do more harm here.

6. Here’s my least favorite part: he wraps up his heartfelt speech by entreating the cashier to “accept them for who they are, and lovingly encourage them to be who they could be”.

NO. NO. NO. That is flat-out health concern trolling about body weight. Patty doesn’t need loving encouragement to become something else. Not from her family, not from her doctor, not from her friends, and not from the cashier. What Patty needs is for the cashier to take her order and give her what she asked for in a professional and courteous way. That’s it.

And honestly, I would’ve watched that video and shared it with others.

There are many other flaws in this video, but alas, my blogging time is up. Readers, what did you like or not like about this video? I’d love to hear from you.

fitness · link round up · weight loss · weight stigma

Fit is a Feminist issue, Friday Link Round Up #97

This week’s link round up focuses on weight loss. If you want to know why a fitness blog cares so much about body image and weight loss, you can read this.

Tl;dr: “Body image is connected to fitness in a variety of ways. It’s both the motivation for lots of women to pursue physical activity. I’ll solve my body image issues by improving my body! Body image anxiety is also the reason lots of women don’t exercise. I can’t go to the gym. I’m too fat! Both of these sets of motivations are problematic.”

Why Everything You’ve Been Told About Weight Loss May Be Wrong

“At any given time, about half of all Americans are trying to lose weight — and we can assume it will be even more than that once everyone emerges from our collective bread-and-cookie-insulated quarantine cocoon. That means millions of people are doing keto, paleo, intermittent fasting, Optavia, Atkins, and all the other diets (many of which we’ve explained and reviewed on GH) that limit what, when and how you eat. And as you can tell from all those “before and after” Instagram shots, some dieters do lose weight — at least at first. But for the majority it inevitably comes back, potentially leading to guilt, disappointment, and the biggest question of all: What am I doing wrong? Why can’t I keep off the weight?

Here’s the truth: It’s not you. It’s biology.

The dirty little secret of the dieting industry is that many diets will fail. But we are still bombarded with the message that if we only find the right diet we will be thin — which has been conflated with “beautiful” in our culture — and all our troubles will melt away along with our love handles. “The diet industry is a $72 billion dollar business, so there’s an extraordinary amount of money that’s hooked into selling the idea that there is something wrong with us, and if only we buy their product, we can find salvation,” says Lindo Bacon, Ph.D., associate nutritionist at UC-Davis and author of Health at Every Size: The Surprising Truth About Your WeightBut according to one well known study at UCLA, not only do most people eventually gain back the weight they lost on diets, but as many as two-thirds may wind up gaining back more.”

Rethinking Fatness: Why Everything You’ve Been Told About Weight May Be Wrong

“Low-fat, low-carb, Paleo, keto, South Beach, intermittent fasting—the list goes on. Given that our culture idealizes thinness and shuns larger bodies, it’s not surprising that nearly one in five midlife women has dieted in the past few years, according to the Centers for Disease Control and Prevention. And many have regained the weight and see themselves as having failed. Less than 1% of very large people got to a “normal” weight at all in a study that included almost 100,000 women, and most who did regained the pounds they had lost within five years.

Some medical experts are now saying what many of us have been desperate to hear: It’s extremely tough to drop weight long-term, for reasons that have nothing to do with willpower—and it may not even be necessary.”

The Last Thing Fat Kids Need

“The message that “good parents” can and should control the number on the scale is literally tearing families apart. Should your child’s weight determine your fitness to be a parent? According to a family court judge in Sussex, England, the answer seems to be yes. In a decision filed last October, which recently made international headlines, District Judge Gillian Ellis ordered that then–16-year-old “Child C” and 13-year-old “Child D” be placed in foster care after their parents failed to help them lose weight. “I know that you love your mother and father very much and I know they love you too,” Ellis wrote. “But I am concerned about your health and the way in which your weight impacts on this.”

What If Everything You Know About Weight Loss Is Wrong?

“Why is it so hard to lose weight? Here’s one reason: A lot of what we all take for granted about weight loss is unproven or flat-out wrong. That’s the bottom line from a special article published in 2013 in the New England Journal of Medicine. The article laid out what works and what doesn’t, and detailed the commonly held weight loss beliefs that are not supported by research. The review also unveiled some of the theories that have not been proven or disproven. Here are some of the most surprising theories, plus what science really says about them”

I lost 100 pounds and didn’t learn a damned thing…

from 2019 by Meagan McGovern

“Man, I really wanted to write a long post about how much better and smarter and amazing I am now that I’ve lost 100 pounds. How much thinner I am. Maybe some clever words about my poor boobs, and about my clothes, and then I could post some before-and-afters, and then the congratulations could pour in.
But the truth is so much more complicated. Losing 100 pounds doesn’t make you smarter, more organized, or able to find your car keys. It doesn’t make me a better wife, a better mother, or a better writer.
Really, it just makes me smaller. And squishier. And more confused than ever about the role of women and weight and hunger and exercise and our culture.
So instead I wrote to Roxane Gay, who seems to write about weight and women with raw truth and clarity. And I’m grateful for it.”

A woman on a treadmill wearing a blue and grey shirt and khaki pants. Photo by Julia Larson on
fitness · health · weight loss · weight stigma

6 things Sam hates about seeing doctors, as a larger person (#reblog, #bloglove)

I’ve been putting off making a doctor’s appointment. Don’t worry. I will, eventually. But here is part of the story about why.

fitness · weight stigma

Fervent hope for 2021: that “The Biggest Loser” won’t be renewed for a 19th season

CONTENT WARNING: this post is about critiques of the reality show “The Biggest Loser”, thanks to the podcast Maintenance Phase, a fat-positive and evidence-based show debunking junk science and myths about health and wellness fads. Their critiques include information about weight loss, extreme exercise, extreme eating restriction, eating disorders, body dysmorphia and mental health that may trigger or traumatize some people. For those who want to read this post, it is in service of reminding us that fat phobia and all its harmful sequelae are still out there, but so are we. Maybe 2021 will be the year to go full-force against such toxic media. Hence the hope.

Now to the post.

One of the horrors of 2020 that you may have missed (which is kind of a blessing) was the reboot of the horror reality show, The Biggest Loser (henceforth called TBL). For those of us who prudently turned away from this abomination, there are articles to provide background and critique of the show.

The Biggest Loser is coming back– but should it?

Is the Biggest Loser even a little bit better?

‘It’s a miracle no one has died yet’: The Biggest Loser returns, despite critics’ warnings

However, if you don’t have the time or interest to wade through all that, podcasters Michael Hobbes and Aubrey Gordon of Maintenance Phase offer up five things wrong with TBL. Of course there are one million and five things wrong with the show, but: their incisive and humorous analysis gives me hope that more people will turn their backs on TBL and on the social evils that support it.

Here’s their first one: TBL is wildly unrealistic. How so? Here are some reasons Mike and Audrey shared:

  1. the kinds of participants chosen for the show were fat people with emotional eating issues, who don’t exercise, and are extremely unhappy with their weight. But, fat people are like all people– some are happier, some less happy; some exercise more, some less; some are happy with their bodies, some less so. Like all the people.

2. The purported method of weight loss: go live in a big ranch house with strangers for months on end, and don’t do anything else. They point out that this method is not found in the medical literature. Good to know.

3. According to the show, the contestants lose an average of 16 pounds/7.25kg in the first week. This rate of supposed weight loss is also not documented in medical studies. Furthermore, Mike and Aubrey tell us that the “first week” is really more like 2–3 weeks, according the contestants. Even so, this is still an unhealthy and unrealistic body change for anyone.

Here’s reason number two: it’s fake and unethical. (that seems like two reasons, but I’m considering it a two-for-one reason).

Case in point: former contestant Kai Hibbard gave interviews about the many ways the producers of TBL would distort results, promote fast weight loss, and otherwise create an environment conducive to disordered eating behavior. Here’s more from this article:

… a runner-up said the show gave her an eating disorder, and seven years later, in a series of 2016 reports, The New York Post quoted contestants who said the show’s doctor and trainer told them to lie about how much they were eating; rigged the weight-ins; and even gave them illegal drugs.

Also, the show features super-processed foods in product placements; TBL has more product placements than any other TV show (533 in 2011).

Reason number three: it’s abusive (and horrible). The contestants are deliberatively portrayed in the most unfavorable way in before pictures, and dolled up to the max in the after pictures. That’s to be expected. But, some contestants have been damned and judged in both their before- and after-weights, some of which are dangerously low according the standard medical science. Further, contestants have reported being encouraged to smoke (to reduce appetite), or pressured to exercise while injured or ill. In the new “wellness” season of TBL, a woman injured her knee doing box jumps, and then is shown using a rowing machine with an ice pack on her knee. No. Just no.

Reason number four: the contestants gain all of the weight back, and suffer permanent harm to their resting metabolic rate. There was a study published here, which you can read about in Scientific American here. Or in the New York Times here. The upshot is that after drastic weight loss, contestants gained a lot of weight back and had a much reduced resting metabolic rate, which the researchers attribute to the drastic weight loss. And this harm isn’t reversible according to our current scientific knowledge.

Last reason, number five: TBL is toxic for everyone of all weights and sizes, blasting false and harmful and distorted messaging telling us: a) what sorts of bodies are the preferred ones; b) that we– the public– can get ourselves one of these preferred bodies; and c) how we can get ourselves one of those preferred bodies. It’s a load of lying lies from a pack of lying liars.

Two other things are worth noting here. First, TBL doesn’t focus on any nutritional information, or talk about cooking, or how to enjoy a greater variety of say, plant-based foods. Oh, no. In fact, the show spends most of its time pushing the contestants to do punishing and painful physical activities, and yelling at them when they are (rightly) tired or or not up to doing them.

For me (and I think for us at Fit is a Feminist Issue), this is (one of) the worst things about TBL: it depicts exercise as a punishment for being fat. And exercise is wholly constituted of activities like box jumps, running on a treadmill, or using a rowing machine indoors. Okay, those things are fine, but what about:

  • hiking
  • dancing
  • yoga
  • biking
  • swimming
  • badminton
  • throwing a damn frisbee around with the dog?

Mike and Aubrey make the point that there’s a whole world of fun physical activity, and TBL loser ignores it. Instead, it recreates “the fat kid’s experience of PE”. Great.

Now that I’ve put you all through the wringer of these five reasons why TBL is awful, what’s the positive takeaway?

I do have one. Here it is. The show debuted in fall 2004. It lasted until 2016. In 2020, they tried to resuscitate it and recast it as a wellness show. But it didn’t work– everyone from fitness experts to health columnists to reality show bloggers hated it. We now see it for what it is– a horrible example of our legacy of fat phobia and body insecurity. And those social maladies are not over.

But: no one is talking about how they’re hoping or even considering that TBL is coming back for another season. It’s 2021 y’all. We got no time for that crap.

fitness · weight stigma

Once more, for the cheap seats: body weight is NOT a lifestyle

CW: discussion and critique of an article claiming complex associations between body weight (and other factors) and chronic illness. I use the phrase “body weight” or BMI instead of this term. I’ve written here about why I don’t use that term.

When you’re a teacher, you know that some lessons are harder to learn than others. When I was a student, the subjunctive tense in Italian never quite sunk in (mi dispiace!) I teach a lot of logic, and I know through long experience where the pitfalls lie (e.g. necessary vs. sufficient conditions; a not-very-clear explanation is here, and a really super-long explanation is here). We teachers do what we can, and usually the confusion clears by exam time.

I really wish the same were true with medical researchers and body weight.

Even smiley faces are sighing over this.
Even smiley faces are sighing over this.

In case you missed it, I’m referring to an article published this spring in JAMA Internal Medicine called “Association of Healthy Lifestyle with Years Lived Without Major Chronic Diseases”. The researchers were looking for a correlation between some combo of what they considered to be lifestyle factors and onset of major chronic illness in a database of 116K people, followed for 15+ years. Here are the factors they used:

Four baseline lifestyle factors (smoking, body mass index, physical activity, and alcohol consumption) were each allocated a score based on risk status: optimal (2 points), intermediate (1 point), or poor (0 points) resulting in an aggregated lifestyle score ranging from 0 (worst) to 8 (best). Sixteen lifestyle profiles were constructed from combinations of these risk factors.

Okay, so smoking and alcohol intake are standardly considered to be health-related behaviors– things we do that affect our health outcomes (e.g. what diseases we get and when). Physical activity also has been well-documented to affect health outcomes; however, calling it a lifestyle oversimplifies it, for instance ignoring the many physical and economic and other barriers to activity that are beyond people’s control.

But then we get to body mass index (BMI). BMI is listed as a lifestyle factor? Huh?

One of these things is not like the others…

Why don’t I think that BMI is a lifestyle factor? Let me turn this over to one of the several responses to the article, published just this week. Authors Kyle, Nadglowski and Stanford write the following:

Treating BMI as a lifestyle behavior obscures the complex etiologies that contribute to BMI… Perhaps more importantly, it promotes a mistaken notion that is the foundation for weight bias and stigma—that [one’s BMI] is [something] that patients choose for themselves through behaviors they elect. The resulting weight bias is well-documented to harm both health and quality of life of patients [with BMI >30].

Body mass index itself is neither a behavior nor a lifestyle, even though health behaviors and lifestyle factors can influence BMI. Many other factors are contributors. 

Yeah, what they said. There are, oh, about three zillion studies showing that body weight is largely genetic and/or heritable (55–70% in many research papers). That means it’s not a health behavior in the way that smoking, alcohol consumption, or physical activity are. Health behaviors affect body weight (just like they affect our cholesterol levels), but that doesn’t make them lifestyle factors, rather they are biological measures used for many purposes.

The original authors (Nyberg, Singh-Manoux and Kivimaki) respond, saying (I’m excerpting but it’s not out of context, I promise):

Maintenance of healthy weight [BMI <25] is indeed part of a healthy lifestyle…

No. Clearly we need to back up and start again.

Spock is in shock. He doesn’t see how they don’t get this, either.

In this commentary on the article, we get another good try at explaining the situation (this is edited to insert BMI as a term):

Such is the nature of implicit bias about [BMIs >30]. … in their hearts, even some very smart people remain certain that body size must be a matter of choice.

Yes, yes, yes. Very many very smart people (including both the study authors and the editors at JAMA Internal Medicine) still believe that body size is a matter of choice. But it’s not. The replies to this article all cite loads of articles in showing that body size is largely heritable, and if you want some refs, ask me in the comments, and I’ll reply with some standard ones.

So, one last time: body weight is not a lifestyle. But I found this website with 50 lifestyle choices to browse among, if you’re feeling like a change. I claim no responsibility for anything having to do with decisions made on the basis of looking, by the way.

I hope this clears things up.

commute · cycling · weight loss · weight stigma

“On yer bike” for oh so many reasons, but weight loss isn’t one of them

In April, which feels like years ago in terms of the pandemic, Catherine asked, Does COVID-19 care what you weigh?

The answer, not surprisingly, then and now, is that it’s complicated.

Catherine concluded, “I don’t work in medicine, but I do know that there is a humongous evidence gap between what’s happening clinically in a particular hospital and its patients (each with their own complex medical and other histories), and what is true about everyone with higher BMIs in the US (not to mention other countries) with respect to risks related to COVID-19. Right now we can’t say much of anything. So maybe we shouldn’t. Which means the answer to my blog title question is, “we don’t have evidence right now to answer this question”. It doesn’t make for exciting news copy, but it’s the closest thing to the truth right now.”

But nevermind the fact that it’s complicated get in the way of a feel-good media campaign. Britain’s Prime Minister Boris Johnson plans an anti-obesity/anti-COVID-19 campaign, with bicycles front and center.

I have lots of complicated thoughts about all of this. And it’s not helped by all of the cycling advocacy groups which make up a good chunk of my social media newsfeed sharing news of the plan enthusiastically. Treehugger proclaims, Miracle Pill Found for Fighting COVID-19: The Bicycle.


First, it’s not at all clear that if you had to pick one thing to work on to improve COVID-19 control in the United Kingdom it’s weight loss. How about mask wearing? Contract tracing? Or speedy testing? There are many areas in which the UK’s COVID-19 response is lacking. I wouldn’t start by blaming individual citizens for their excess pounds.

Second, it’s not clear that there is a shred of evidence that ‘eat less, move more’ public health campaigns do anything other than shame fat people.

Here’s an obesity doctor’s assessment, “I find it impossible to fathom that anyone with even an ounce of knowledge of the complex, multifactorial, chronic, and often progressive nature of obesity should in this day and age still fail to understand that the proposed plan, which includes the usual talk of changing the food environment (largely by appealing to personal responsibility) and a 12-week weight loss plan app [sic], focussed on healthy living (read, “eat-less-move-more”), is about as likely to noticeably reduce obesity in the UK population, as taking out a full page ad in The Sunday Times stating that “Obesity is bad!”.”

And here’s Susie Orbach’s response in the Guardian: Britain’s obesity strategy ignores the science: dieting doesn’t work.

Third, there are so many, many reasons to encourage people to ride bikes–less pollution, better mental health, happiness, etc–we don’t need to add one that isn’t true to the list.

Note that Boris, like me, is a regular cyclist, who is thought to be by many people someone who could do to lose a few pounds, or even stones, as they say over there. Normally I’m out there defending fat cyclists like me and Boris. See Fat cyclists in the news and Big women on bikes and Pretty fast for a big girl and Not all cyclists are thin and Fat lass at the front?. It’s a thing I write about a lot.

But here he is, a committed, regular, everyday cyclist out there pushing bike riding for weight loss.

Note we’re different kinds of cyclists but neither of us is thin.

I love bikes but I hate to hear them promoted as weight loss tools.

Because, they’re not.

I love to ride my bike. I’m on track to ride 5000 km this year, or about a 100 km a week. You can follow me on Strava, here. On ZwiftPower I’m here. I’ve been doing this for years and I can assure you it’s not making me any smaller.

And I worry that if people start riding to lose weight, and they don’t lose weight, they’ll quit and miss out on all the other benefits of moving through life on two wheels. For example, cyclists are the happiest of commuters.

What bicycling feels like every single time!

In my post on reasons to ride I give some of my reasons for riding a bike, “There are lots and lots of reasons to ride bikes. Some are health related. It’s also a terrific stress relief, and it’s good for the environment. It’s an easy way to incorporate exercise into your day. It’s good to spend more time outside. As well, it’s a sensible financial move. Driving, once you add up the costs of car payments, parking, insurance, and gas is an expensive way to get around. And I agree with all of these reasons but on their own they might not be enough to get me out the door and on my bike. What does it then? The sheer joy of cycling. On my bike I feel like I’m 12 again. Whee, zoom!”

Here are some more reasons people ride: