"Fat Chat Feed" via Fat in Google Reader

Job requirements

2013-05-23T23:13:17Z

“Put this all together and it means the IRS needs tens of thousands of people who are (a) smart, (b) willing to do really tedious work, (c) for moderate wages, (d) while working for a soul-crushing bureaucracy, and (e) being loathed by all right-thinking people. Does this sound to you like a recipe for disaster? Me too.”

— Mother Jones

Wow…to a certain extent this sounds a bit like working in child care, or elder care, or Microsoft tech support. (To name a few jobs I’ve done that were exacting and received little respect or pay.) But the IRS is probably worse.

Filed under: News, Work

OoTD No. 32 – Smells Like Teen Spirit

2013-05-23T14:14:52Z

I am officially writing to you from my late 20s, as on Wednesday, I turned the ripe old age of 27. Interestingly enough, when I was little this was the age at which I thought I’d be getting married and having babies. I don’t know why I picked this number in particular; ’27′ just sounded terribly mature. (In reality I live in sin with the Boyfriend, dress like a teenager, and forget to buy groceries every other week. SHOWS WHAT YOU KNOW, LITTLE FRANCES.)

To celebrate this momentous occasion, a bunch of mates and I went to a 90s-themed dance party called Teen Spirit, which is a ridiculous and amazing club night that I love with all my heart. Since I’m still firmly ensconced in my 90s obsession, I decided to dress the part.

I can cross another item off my 90s extravaganza wishlist: I am now the owner of the PERFECT leather mini backpack.

I had forgotten how spacious these things are. This wee backpack is smaller than my handbag, but with its multitude of zips and hidden pockets, it fits just as much. I bloody love it… so much so that this cheap, tacky thing has replaced Marc Jacobs. I’m bringing ‘em back.

And here is me and my outfit in action. The DJs played Pony and Ignition (Remix) and Common People and I shout sang and danced dirty and saw 18 years olds making out like their lives depended on it.

It was a spectacular night.

Top: Worn By from Asos – size L. Currently available (and on sale!)
Shorts: Witchery – size 16. Old collection.
Stockings: Kayser Plus Fuller Figure Sheer Nylon Pantyhose from Myer – size 1 (supposedly equivalent to a size 18/20 but it fit size 16 me perfectly). Currently available.
Backpack: Second hand from GAMMAvintage
Shoes: Buffalo x Solestruck – size 10. Currently available.

Amy Lamé in Unhappy Birthday

2013-05-23T13:11:00Z

I'm late to the party but had an opportunity to get smeared with cake and declared the face of the British obesity epidemic yesterday evening as an member of the audience for Amy Lamé's show Unhappy Birthday. This is running for a little while yet, so there's still a chance to go and see it at the lovely Camden People's Theatre in London.

Unhappy Birthday takes the form of Amy's birthday party; there are party poppers and little conical hats for everyone, a tray of snacks, a big present and a seat reserved for the guest of honour: Morrissey. We hear stories of Amy growing up, and her progression from unhinged Morrissey superfan to even more unhinged Morrissey superfan. Things soon start to unravel and by the end of the show our hostess has, variously, threatened, cajoled, sanctified, smooched and fed us.

Some things worth remarking upon:

Unhappy Birthday is the latest product from the house of Amy Lamé and Scottee, who directed the show. If you liked Hamburger Queen, you'll love this. Little touches like sequins, jokes about performance art, shimmer curtains, dressing up, smeared lipstick are like hallmarks of this beautiful, collaborative, creative work-friendship and are a pleasure to witness.
It's not a play about fat, but fat is in there or, rather, morbid obesity. In a climate where academics are calling for policy to pressure media into producing positive images of fat people, Unhappy Birthday reminds me of the delights of mucking about in the gutter. As a person in the public eye, it's really amazing and brilliant to see Amy embrace the grotesque, the un-pretty, the demented, the 'ugly-fat'. She deconstructs her own celebrity, really goes there fearlessly and it's beautiful.
Bevin Branlandingham sometimes talks about being called Too Much. The Amy of the show is gleefully Too Much: big, in your face, wild eyes, out of control, running around, yelling "I've been on the TV!" This is the image that anyone who ever gets told they should be quiet, be polite and take up less space in the world should hold in their head.
The production design is gorgeous. You get a little zine as a programme, the lighting and projections are pretty, props are revealed from beautiful boxes, there's mess. It's minimalist and maximalist all at once.

Some people I know elsewhere have been raving about Samuel D. Hunter's play The Whale. But performance that's engaged with fat to a greater or lesser extent does not have to be limited to a skinny guy blobbing around a stage in a fatsuit, offering a mawkish rendering of what it is to be fat, in venues that are likely inaccessible to actual superfat people who might want to set folks straight. I see Unhappy Birthday within a scene that includes people like Glenn Marla and Hana Malia, the duo formerly known as Fat Femme Mafia, Emma Corbett-Ashby/Goldie Dartmouth, Rebel Cupcake's roster of performers, Shazzam, even Beth Ditto, who bring their lived understanding of queer fat to performance in diverse, dazzling ways. This is the stuff that makes you feel witnessed, validated, entertained and glad to be alive.

Ok, that's all, go and see it.

Adipositivity 607

2013-05-22T00:00:00Z

Adipose: Of or relating to fat. Positivity: Characterized by or displaying acceptance or affirmation. MISSION: The Adipositivity Project aims to promote size acceptance, not by listing the merits of big people, or detailing examples of excellence (these things are easily seen all around us), but rather, through a visual display of fat physicality. The sort that's normally unseen. The hope is to widen definitions of physical beauty. Literally. The photographs here are sometimes close details of the fat female form, often without the inclusion of faces. One reason for this is to coax observers into imagining they're looking at the fat women in their own lives, ideally then accepting them as having aesthetic appeal which, for better or worse, often translates into more complete forms of acceptance. The women you see in these images are educators, executives, mothers, musicians, professionals, performers, artists, activists, clerks, and writers. They are perhaps even the women you've clucked at on the subway, rolled your eyes at in the market, or joked about with your friends. This is what they look like with their clothes off. Some are showing you their bodies proudly. Others timidly. And some quite reluctantly. But they all share a determination in altering commonly accepted notions of a narrow and specific beauty ideal. Bookmark adipositivity.com and check back often, as new photographs are added regularly(ish). And please help spread the message. The Adipositivity Project: Changing attitudes about the aesthetic validity of big women, one fat fanny at a time. ABOUT THE PHOTOGRAPHER: Substantia Jones’ photography has been exhibited in galleries and museums throughout the US East Coast, and has appeared in The New York Times, Time Out New York, and some other publications she can’t recall at this time, but you probably haven’t heard of them anyway. She is biographied in the 2006 Who’s Who in America (though under the name her momma gave her), and back in the day, she won some photography awards which would sound somewhat Mayberry if listed here, but at the time, they damn near made her cry. Still kinda do. She lives in Manhattan, where she also sometimes steps out (more like lays around) in front of the camera, and on some of those occasions, the snapping is done by her trusty sidekick, Dr. H, who also fetches her banana popsicles and maintains her muse, a certain pancake colored dog who’s asked that his name not be mentioned on the Internet. Ms. Jones likes crispy calamari, Squidbillies, and the ika okonomiyaki from Otafuku in the East Village, if only the lines weren’t so long. Thou shalt not reproduce without permission. Except for babies. Make all o' them you want. © The Adipositivity Project 2007-2013

Weight Stigma Conference Talk on YouTube

2013-05-22T11:50:00Z

I was invited to give a presentation at the first Weight Stigma conference last week. The conference was organised by Angela Meadows, a PhD student at Birmingham University. I spoke about Research Justice.

Research Justice is a concept emerging from activist communities in the US, and has roots in disability activism. It proposes that research subjects should have a voice in the research undertaken about them; it also treats research as a tool to support social change.

Research Justice really excites me because it adds a practical dimension to the discussion about the failings of obesity research, and proposes measures for building research projects that have more direct benefit to fat people.

In the presentation I explained what is meant by Research Justice; why it's important that people get on board with it in relation to fat and stigma; and I showed what it might look like in real-life settings by making some mock-ups of a series of web pages.

I recorded my talk and have added it to my slides. You can watch and listen to it here on YouTube. There were some questions afterwards but, since I do not have people's consent to include them, I have cut them out.

When Angela invited me to talk, some months ago, I knew that I wanted to present something about Research Justice, because this had a powerful effect on the way I approached my own research. I didn't realise how prescient the subject would be on the day.

I appreciate the work undertaken by Angela and the other organisers and volunteers, it was very clear that people worked extremely hard to get the conference off the ground and are deeply committed to the work. I also mourn the fact that there are so few spaces that engage with any critical voices on obesity at all. Our ESRC Fat Studies seminars ended in 2011, and since then Fat Studies in the UK has become fairly quiet, and has also become subsumed into the rhetoric of Health At Every Size. Not that anyone has gone away; there were many speakers at the Weight Stigma conference, and opportunities for debate across fat and obesity frameworks. There's still so much to say, and a lot of work to be done. Another Weight Stigma conference has been set for next year, and I hope that other gatherings spin off from it too.

The conference raised many questions for me about who gets to talk about fat. I think, but I'm not sure, that I was the only speaker out of 17 who identified explicitly as fat and brought that identity to the work I was presenting. I wonder whether or not this will continue in subsequent conferences. I don't think that fat people are the only people allowed to talk about fat, fat stuff is a subject for everybody, but I think it's perplexing that the people who research and theorise fat, or at least those academics who are visible in that work, are generally normatively-sized. This is not necessarily to criticise their work (some of it's great, some not) but there are conversations about thin privilege and its effects on the work that are not yet happening within this milieu and which, I think, need to be expressed. Additionally, there are plenty of Fat Studies scholars, and activists too, who are fat, who include the knowledge they have as fat people into their work, and who would be great speakers at conferences about fat and stigma.

(By the way, during one of the breaks I asked a couple of people who enjoyed my talk, who wanted to know more, and who work for a fairly trad anti-obesity organisation why they thought people like me never get invited to speak at those £500-a-ticket obesity conferences. Answer: because my presence would completely undermine everything! I think I may have blown their minds with that one, whoops).

Where fat people are in the minority at an event about fatness, debate may be possible but this does not take place on a level playing field. Instead of an environment where open sharing of ideas is possible, only the very bravest and articulate – or furious! – are able to speak because the setting is risky. Few people have the security of a PhD in contributing to debate and it's easy for academics to shoot down comments made by people who don't share their privilege. It means that people with lived experience of fatness, or activists and allies, become marginalised where academic discourse is regarded as the gold standard. For example, one woman I spoke to at the conference, a fat woman new to activism, was talking to a thin academic, a presenter, and when he asked who she was and what she did – she's not an academic – patronised her by saying: "Oh! You're the general public!"

Another incident intrigued me on the day. An academic said some fatphobic things and this was down-played by two others. He'd dropped a bomb, stating that even if fat people present to him with 'healthy' (whatever that means) behaviours, he will remind them that their fat bodies are not acceptable and that they need to lose weight. When questioned on this, he shrugged and remarked: "It's just the truth." A fat woman tried to tear him a new one, and during the course of the day he was on the receiving end of some stink-eye from others. Stink-eye is what maligned people resort to when all else fails and they know they're not going to be heard. Yet another academic tried to force some kind of agreement and common ground with him, appealing to appealing to manners and polite debate. The fatphobic speaker was later praised as "brave" for having spoken; never mind that he's a privileged academic who does this kind of thing for a living and whose work is deeply embedded within a dominant discourse from which he benefits in terms of money and status. Later the audience was chastised by another speaker for being "mean" to him because, presumably, fat people and our allies are not allowed to be extremely angry when someone pulls this crap in a setting where we may have assumed folks will be advocating for us.

The day was pretty exhausting and I was left wondering where Weight Stigma might go, whether it will become another kind of obesity conference, whether it will build capacity in fat people within and beyond the academy to articulate our own lives, and about the role of the academy and the professionalisation of fat and obesity discourse within the conference.

I am really glad that I was invited to speak at Weight Stigma, and very happy that the conference offered financial assistance to people who could not otherwise afford to attend. Great, too, that they offered Continuing Professional Development accreditation to people. I'm thinking how capacity in non-academic participants could be extended, perhaps through pre-conference workshops, or some kind of orientation event. I hope very much that the people who continue Weight Stigma undertake the vital work of developing fat community links, and I am available to help facilitate that if they are interested.

Sorry! No blog post this week, join me again on Monday.

2013-05-21T19:21:10Z

Sorry! No blog post this week, join me again on Monday.

Crohn’s disease? Congrats on losing weight during a flare. . . .

2013-05-21T17:05:01Z

Rachel writes:
(I really appreciate your blog! I am not very overweight, but I still get judgment for it all the time, so I can only imagine what reality is like for other people. Ugh.)

I’m a 21-year-old woman and have somewhat struggled with my weight since hitting puberty (I was a 14/16 US in ninth grade). I’m not obese, but I’m tall and big-boned with slightly odd body proportions, making my current 10/12 size look bigger than it really is, though I’m really only a few pounds over my max healthy weight.

Anyway, I was diagnosed in the summer of 2012 with Crohn’s disease, a serious digestive disease that affects the way my body digests food and absorbs nutrients. Many patients lose massive amounts of weight because they literally cannot digest food. The way I cope with the debilitating pain and diarrhea is by overeating between flares – my body’s way of trying to make up for malnutrition while I can handle eating solid food. In other words, I look healthier than I really am.

After my diagnosis, I had a major flare that lasted the second half of the fall of 2012, and I was very sick.

However, when I went to see my gastroenterologist in December 2012 for a follow-up appointment, the intake nurse (his medical assistant) took my weight and then CONGRATULATED me for losing 10 pounds!

She is a specialist in gastrointestinal diseases! She of all people should know that such rapid weight loss in a Crohn’s patient is a sign of serious complications!

I still struggle with guilt because I have Crohn’s disease and yet am still overweight.

(PS: She was not exactly thin herself, either!)

Attractive & Fat

2013-05-21T15:27:56Z

More on A&F: Jes over at The Militant Baker posts her response to the Abercrombie & Fitch CEO, proving that it is possible for some fatties to wear A&F, and do so quite well: http://www.themilitantbaker.com/2013/05/to-mike-jeffries-co-abercrombie-fitch.html

Why It’s Okay To Be Fat: TedX talk from Golda Poretsky

2013-05-20T19:25:31Z

Golda Poretsky of BodyLoveWellness did a TedX talk on why it’s okay to be fat.

Here’s a link to the chart she shows on weight and longevity, along with the full text of the paper it’s from.

Filed under: Dieting/WLS, fat acceptance, HAES

Music Monday

2013-05-20T15:28:06Z

This week some mentioned the anniversary of Jim Henson’s death, which reminded me of the song “Storyteller.” In concert it’s been stated it was written in response to Jim Henson’s passing.

Song credits: Performed by Alexander James Adams; lyrics & music by Heather Alexander.

Filed under: Music

Fattylympics Talk on YouTube

2013-05-20T12:04:00Z

I was in Bradford recently, giving a talk about The Fattylympics for an academic/activist gathering called Just Do(ing) It, Again: The Politics of DIY and Self-Organised Culture.

It's getting close to being a year since The Fattylympics took place, and a good time to reflect on it. Although there were problems on the day, I think it offers a good example of how to make multi-layered activist events that appeal to many different kinds of people, don't cost very much, and which push the boundaries of what can be considered activism (a good thing, in my opinion, because it enables more people to engage with activism in their own ways). Not only that, but we produced this event in a context that was pretty repressive by first world standards. I think The Fattylympics is also significant because it was a joyous event, it showed that the work of social justice does not have to be a hand-wringing affair.

I made a slideshow of the audio of my talk and some images from The Fattylympics and have made it available on YouTube. There were some questions afterwards, but I did not include these as I thought it would be uncool to include people's voices without their consent. The whole thing lasts about 25 minutes. There's some swearing, beware, but also plenty of context and description about how and why we put the event together.

I want to add that the gathering where I spoke was a bit of a strange one. Although it took place in a well-respected (though inaccessible) autonomous space, it was very much an academic affair. What's more, I was really shocked by the sexism within the symposium. Two panels of white men, with tokenised women moderators, set the tone of the event. This was really alien to me! I come from a DIY community where feminism, queers, and increasingly people of colour, are central to the scene. Some of the men's work was very old, and two ethnographers, when pulled on their samples, admitted that they had very much marginalised women in their research. The feminist and queer speakers were put together at the end in a panel called 'Case Studies,' even though I mention some theory in my presentation, and even though some of the men's presentations could also have been called 'Case Studies'.

It really was vexing to witness this, and small moments, such as when one panellist got his fellow speakers a glass of beer, but not the queer woman moderator (presumably she is too ladylike to enjoy a drink?), spelled out how invisible and marginal many people's voices were on the day. I heard a lot of talk from the men about class struggle, but feminism or other theoretical frameworks, if mentioned at all, were very much added as an afterthought, or a touchstone to make the speaker appear right on.

I'm sure this kind of thing is familiar to people who have an academic interest in punk, or who spend time with straight men, but for me it was quite an unpleasant eye-opener. What's even more dismaying is that our panel of feminists and queers was the most well-attended and popular of the day. I wish what we brought had been more central to the event.

Cooper, C. (2013) Doing the Dance of Disrespect: The Fattylympics. Just Do(ing) It, Again: The Politics of DIY and Self-Organised Culture. Bradford: 1 in 12 Club/Bradford University. 11 May.

Join My Fat Ass in Doing Something for All of Us

2013-05-20T02:42:45Z

Want to do something important?

Meetings are going on right now where employers are asking the EEOC (Equal Employment Opportunity Commission) to set guidelines and provide clarification regarding employer “wellness programs”; and the EEOC would like input.

http://www.shrm.org/hrdisciplines/benefits/Articles/Pages/Wellness-EEOC.aspx

Take a look at the concerns of the organizations that represent the rights of “people” (i.e., employees) and the concerns of the lawyers representing the employers. Uh-huh.

I don’t think it takes a rocket scientist to see that the employee-groups are concerned about discrimination; and the employers are concerned about the “effectiveness” of their programs.

The employers are concerned about the effectiveness of being able to get their hands on personal, private, protected health information of their employees; they are concerned about the effectiveness of the program to allow them to pass on more of the cost of health insurance to the people who need the coverage the most and are least able to bear that extra burden; and they are concerned about the effectiveness of using the program to weed out employees who are otherwise included in protected classes – like race, gender, and age.

Here is what I e-mailed to the EEOC:

It is becoming more and more clear that these programs are being used not to improve the health of employees but as a way to discriminate against all but a group of “healthy” individuals and to pass on rising insurance costs to those employees who will suffer the most from such penalization.

If the true concern is “wellness”, then participation should be sufficient without arbitrary goals such as BMI.

It is even more disconcerting that employers are demanding access to private (and protected) health information to which they have no right. There is no proper business reason for an employer to have access to health information on its employees, except in certain specific instances (such as drug testing).

To require an employee to achieve specific outcomes from a wellness program is unquestionably discriminatory. People with certain disabilities, with certain genetic traits, of certain ethnic background, of lower socioeconomic background, of a certain age or gender may not be able to achieve those (arbitrary) outcomes; or to achieve those outcomes may impose a disproportionate burden on those employees in attempting to do so.

I urge you to look closely at the motives of employer “wellness” programs; and that you create guidelines that protect the employee from unwarranted intrusion by an employer.

Thank you for your time and consideration.

Terri Weitze

Other people’s bodies are none of your business, not to touch, to judge, or to publicly comment upon. (Leslie Kinzel)

(And yes, I kept my current tagline in, because I think it is pertinent to the issue.)

If you are so inclined, I encourage you to e-mail your thoughts, concerns and comments to the EEOC before May 23, 2013:

Commissionmeetingcomments@eeoc.gov.

Comments will be made public, and the sender’s e-mail address will automatically appear on the message. Public comments may also be mailed to Commission Meeting, EEOC Executive Officer, 131 M St. N.E., Washington, DC 20507. Written testimony delivered at the meeting is available on the EEOC website.

Big Stinky

2013-05-18T23:37:44Z

Big Think just laid a big stinky.

Big Think is a YouTube channel that features four minute lectures by smart, cool people (like Neil DeGrasse Tyson and Penn Jillette, for example), and some not so cool people. I usually can tell if I’m going to hate a video by the title, and I avoid those that I hate, but this video was called Big Think Mentor, which made me think of mentoring children, which sounded good.

I played it, and the first clip was a dude talking about how thin people can be unhealthy. That’s not a big shocker, and we in the fat rights community often like to point that out as well, to show how it’s unfair to demonize fatties as unhealthy. (It’s actually unfair to demonize fatties even if we’re unhealthy, but that’s another post.) The problem with this guy is he used the phrase “metabolically obese” for unhealthy thin people.

Using the word “obese” to indicate “unhealthy” isn’t big thinking, it’s prejudicial thinking. Someone who sees data showing that thin people can be unfit, and that fat people can be fit, and expressing that by saying (in essence) “thin people can be fat” is using existing prejudices to evoke an emotional reaction. “Gosh, I hate fat people, and I’m thin, but if I’m also unhealthy, that means I’m as bad as a fatty, so I’d better get healthy so I’m not so loathesome. Because better health isn’t enough of a motivating force.”

I guess the video is selling a computer program to help people live better, but if their motivating force is prejudice, I’m not buying.

The Ambercrombie and Fitch problem.

2013-05-18T01:17:00Z

So I'm going to assume we've all heard about the bullshit the CEO/whatever from AF has said about fat people.

Now first let's understand that this is not shocking. It's not new. It's not a surprise at all. If you have seen any of their adverts, their products etc you'd be pretty fully aware that they are a no fat people store.

Via facebook I saw that there is an Occupy AF thing going on and I have so many problems with this I couldn't fit it all into a facebook comment.

Buckle your seatbelts.

From the facebook page:

>We can't change their business practices, and we can't (and don't want to) force them to make larger sizes. We CAN let them know that bullying is unacceptable, and we CAN change the rarified atmosphere in their store.
This is NOT a "protest". Please do not bring signs, signs, or chant. Just go to Abercrombie and Fitch with as many large, unpopular, or possibly just level-headed people that you know, and shop. Try things on that don't fit. Don't buy anything. Just make the store a place filled with the people that they don't want there.

This one day is just a beginning, a symbol. Every time you are in the mall, go in the store. Don't buy anything, just be there to make sure that their goal of their store being filled with only thin and beautiful people is thwarted. Make it an unpleasant place for the "cool" and "beautiful" kids to shop.

Also from the page:

Remember: This is NOT a "protest". No signs, no chanting, no destruction of property (though if you own A&F clothing that you want to "alter" and wear, feel free). Just browse (but don't buy). Fill the store with people that they don't want there, making it unpleasant for the people they DO want there.

My first problem with this sort of thing is that the action is directed to the wrong people.

Let's make this perfectly clear.

I do not care where other people with bodies different from mine shop. As I've discussed where and how people shop is not always a tacit agreement about a companies business model, it's not always about being cool and pretty, nor is it always a cut and dried decision. I just posted about that here.

I cannot support the idea that making the consumers of a product feel badly about their purchases or as the about statement says, make them uncomfortable is reasonable or okay.

As I say over and over again, unless you are coming out of pocket to pay for other peoples clothing, food, shelter, cars etc. It's really not your place or business to bother them about it.

Moving along.

Let's talk about being a retail employee shall we?

As we all know being poor or jobless really sucks. It is a rarified privilege to really have the option of saying, no I don't want this job because the CEO is a dick.

Most retail (especially in chain stores) employees make minimum wage and most are part time without medical insurance.

Let's have a quick look at minimum wage. Currently the federally mandated minimum wage is 7.25$ an hour.

Before taxes if you worked a full 40 hour work week you would make, 290$ a week.

When contrasted with a multi millionare boss and customers who can afford to shop in a store at full price, what effect does making those people uncomfortable have?

Let's see.

Having a planned action in a store even if it is supposed to be not a protest means that those people (who are presumably poor especially if they are adults who are not supported by parents or spouses) more stressed out. Working retail, especially in a store that people at large have a problem with sucks. Add in the stress of poverty and then a bunch of people intentionally wanting to fuck up your day and it's really not great.

Salespeople in retail stores have the least amount of power in the structure of retail.

Why focus the energy on people who have no power to change anything?

Why put the onus of change on people who often if they do become a squeaky wheel will lose their jobs?

Would the people who plan to occupy AF give those people jobs if they lose them? :Make them feel better if at the next store meeting they get berated for "not doing something" about the situation?

I worked retail and I remember things like this happening on a small scale. There was a lot of pressure to not let it happen but no real power to do so.

Yes, people working there have chosen to work there but, when you need to feed and clothe yourself or support your family, money comes first for a lot of people.

Not everyone has the privilege of letting their own personal ethics dictate every choice they make.

I felt the same way when people wanted to occupy target stores.

No one has ever given me a good answer as to why it is that these type of things always focus on the people with the least amount of pull. Or told me how those people are supposed to create a change in a company they don't own and have no influence as to how it is run.

If the point is to just be irritating and potentially cause employee stress, it's a good plan.

If there is a desire to make some change and awareness among the people who can make a difference there are other annoying things to do.

For instance.

If you click here you can see an array of means of contacting AF. If you want to make them uncomfortable it is very simple to spend a little while writing a short form style email. Have all of the people you want to occupy, send the same message. Every day at the same time. Every. Day. Spread the message on facebook, message boards and other social media and ask people to join in.

Read their diversity statement and ask pointed questions about it. Every. Day. If you get a response, CC EVERYONE you can think of and share the information you get.

Also at the end of everything, there is not a lot anyone can do to change that mans mind or his policies. There is merit in watching to see if they violate their own or state or federal policies Call the right people about that. Remind them of every misstep if they violate those policies.

Basically don't screw with the people with the least power.

Let me say it again.

Regardless of your personal ability to decide where you work, how and where you spend your money etc based strictly on your idea of ethics and morality that's awesome. Get it. Do it.

However, do remember that not everyone is in that position and it is patently unfair and frankly a jerk move to harass, bother or make the rest of us uncomfortable.

Also in case you don't already know, I think that the CEO of AF is a fucking asshole. Very typical sizeist, classist rich White dude douchebag. I hope he has the eternal fiery shits. I hope he gets the shits so bad he needs an anal retread.

I don't care what he looks like, and yes if part of your issue with him is his looks please stop. Not an okay thing. I do care that he's a douchebag.

I am very into the idea of letting the horrified public make sure he knows how much of a douchebag we think he is.

I'm not okay with doing the same to the people who work at his company. Especially the ones on the bottom.

Homo Out.

If you are seeing this post anywhere other than http://blog.nudemuse.org or via a feed reader it has been stolen.

Placental Complications Increase With Prior Cesarean

2013-05-17T20:08:00Z

April was Cesarean Awareness Month. It was sponsored by The International Cesarean Awareness Network (ICAN), which seeks to help support women after cesareans, to raise awareness of the implications of a high cesarean rate, and to keep Vaginal Birth After Cesarean (VBAC) an accessible choice for women.

As a follow-up to Cesarean Awareness Month, let's discuss some of the possible complications of too many cesareans.

The importance of this discussion is highlighted this week by the recent tragic story of a woman who died from complications of Placenta Accreta during her sixth cesarean.

The fact is that each successive cesarean increases the risk for abnormal implantation of the placenta in future pregnancies, and this can be life-threatening to both mother and baby.

This is not to imply that all cesareans are bad; many are truly life-saving and necessary, and many others are probably prudent. However, many non-indicated cesareans are being done these days. Cesareans are not without risks and this mother's death shows why they should not be done without good reason, especially multiple repeat cesareans.

The extremely high cesarean rates and lack of VBAC access in certain areas of this country and around the world has very distinct public health implications that should not be ignored.

One of those public health implications is the rising incidence of placenta previa and placenta accreta. As one study summarized:

Placenta accreta is recognized as a catastrophic disease in obstetrics. Diagnosed incidentally, it has been a rare disease in previous decades prior [to] indiscriminate use of cesarean delivery. The World Health Organization has recently highlighted this disease as a new pandemic, which is directly related to patients who have two or more caesarean sections.

Abnormal Placentation

One of the most significant risks after having had a cesarean section is abnormal placental implantation in a future pregnancy. There are several different types of these, which include:

Placenta Previa (the placenta implants too low, near or over the cervix)
Placenta Accreta (the placenta attaches abnormally and has difficulty detaching later)
Placenta Increta (the placenta grows into the uterine muscle and has difficulty detaching)
Placenta Percreta (the placenta grows through the uterus and into surrounding organs)

In addition, there is an increased risk of the placenta pulling away from the uterine wall prematurely (called placental abruption). This, too, can be a serious complication.

Today we'll discuss overall increases in placental complications after prior cesareans; in later posts, we'll discuss each placental complication in more detail.

The big question is why a subsequent pregnancy after cesarean is at risk for placental issues. Although the exact mechanism is not clear, most authorities agree that the damage to the lining of the uterus from a cesarean may predispose to placental implantation and/or detachment issues, especially if the fertilized egg implants near the scarred area.

Of course, it's not just cesareans; any damage to the lining of the uterus can predispose to placental issues. A D&C procedure, whether after a miscarriage or to terminate a pregnancy, can cause problems with the uterine lining. On the other hand, research differs on whether myomectomy (fibroid removal) does or does not have an association with placental issues.

Even such minor factors as uterine infection, smoking, drug or alcohol use, older age, or many pregnancies can predispose to placental implantation issues. The theory is that they also damage the uterine lining, causing problems when the next pregnancy implants.

However, it's clear from research that one of the most powerful risk factors for placental issues is a prior cesarean, and that the risk increases as the number of prior cesareans increases. This means that this condition is often iatrogenic (caused by the physician) and is a preventable risk in many cases.

Increase in Placental Complications

Research shows that the incidence of placental complications has risen in parallel with the burgeoning cesarean rate.

For example, one recent study on placenta accreta shows that

The incidence of placenta accreta has increased 13-fold since the early 1900s and directly correlates with the increasing cesarean delivery rate.

Another study that did a meta-analysis of the impact of multiple repeat cesareans found:

The incidence of placenta previa increased from 10/1000 deliveries with 1 previous cesarean delivery to 28/1000 with ≥3 cesarean deliveries.

Now, keep in mind that most women with three or more cesareans still don't experience a previa. However, to increase from an incidence of 1% to 2.8% is a serious increase, given the risks associated with previas.

The authors of that meta-analysis also pointed out that women with previa who have had prior cesareans are at far greater risk for the very serious condition of Placenta Accreta than women with previa who have not had prior cesareans.

Compared with women with previa and no previous cesarean delivery, women with previa and ≥3 cesarean deliveries had a statistically significant increased risk of accreta (3.3-4% vs 50-67%), hysterectomy (0.7-4% vs 50-67%), and composite maternal morbidity (15% vs 83%; odds ratio, 33.6; 95% confidence interval, 14.6-77.4).

In other words, the risk for having both previa and accreta jumped from 3-4% to 50-70% if you had three or more prior cesareans. Clearly, multiple cesareans strongly increase the risk for placental issues in future pregnancies.

Many of these studies use risk ratios to compare the risk. This is useful in some ways, but mothers deserve to know what the exact numerical risk is for these conditions. A 2006 large study was able to quantify this for women. In their study, they found that accreta was present in:

0.24% of women undergoing their first cesarean
0.31% of women having their second cesarean
0.57% of women having their third cesarean
2.13% of women having their fourth cesarean
2.33% of women having their fifth cesarean
6.74% of women having their sixth or more cesarean

In addition, they found that a hysterectomy was required in:

0.65% of women having their first cesarean
0.42% of women having their second cesarean
0.90% of women having their third cesarean
2.41% of women having their fourth cesarean
3.49% of women having their fifth cesarean
8.99% of women having their sixth or more cesarean

Obviously, the more cesareans you have, the more at-risk you are for complications. Complications like previa and accreta really start to rise after 3-4 or more cesareans.

However, sometimes these complications happen when a woman has "only" had one or two prior cesareans. One study found that having a cesarean for the first birth raised the risk for placental abruption in the second pregnancy by 40% and for placenta previa by 47%. So although the risks are greatest with 3 or more cesareans, poor outcomes can happen even after only one or two cesareans. That's why it's important to prevent every cesarean that is not truly medically-indicated.

Even more important is to prevent the automatic repeat cesarean that happens to most women in this country (and in many countries around the world). In many areas now, once a woman has a cesarean, she is not "allowed" to choose (or is pressured out of) having a subsequent vaginal birth. And this is what leads to many cases of placental complications.

Most women will not experience severe complications despite undergoing multiple cesareans, but some WILL ─ like the woman who died recently while having her sixth cesarean. Now her children have to grow up without their mother.

This is why it is so important to prevent that first cesarean whenever possible, and why it is absolutely critical for women to have access to VBAC instead of being forced into cesarean after cesarean.

References

Increase in Incidence of Abnormal Placentation

Obstet Gynecol Clin North Am. 2013 Mar;40(1):137-54. doi: 10.1016/j.ogc.2012.12.002. Placenta accreta, increta, and percreta. Wortman AC, Alexander JM. PMID: 23466142

Placenta accreta is an abnormal adherence of the placenta to the uterine wall that can lead to significant maternal morbidity and mortality. The incidence of placenta accreta has increased 13-fold since the early 1900s and directly correlates with the increasing cesarean delivery rate. The prenatal diagnosis of placenta accreta by ultrasound along with risk factors including placenta previa and prior cesarean delivery can aid in delivery planning and improved outcomes. Referral to a tertiary care center and the use of a multidisciplinary care team is recommended.

Risk Factors for Abnormal Placentation

Am J Obstet Gynecol. 2005 May;192(5):1458-61. Abnormal placentation: twenty-year analysis. Wu S, Kocherginsky M, Hibbard JU. PMID: 15902137

OBJECTIVE: This study was undertaken to determine whether the rate of abnormal placentation is increasing in conjunction with the cesarean rate and to evaluate incidence, risk factors, and outcomes...RESULTS: There were 64,359 deliveries, with cesarean rates increasing from 12.5% (1982) to 23.5% (2002). The overall incidence of placenta accreta was 1 in 533. Significant risk factors for placenta accreta in our final analysis included advancing maternal age (odds ratio [OR] 1.13, 95% CI 1.089-1.194, P < .0001), 2 or more cesarean deliveries (OR 8.6, 95% CI 3.536-21.078, P < .0001), and previa (OR 51.4, 95% CI: 10.646-248.390, P < .0001). CONCLUSION: The rate of placenta accreta increased in conjunction with cesarean deliveries; the most important risk factors were previous cesarean delivery, previa, and advanced maternal age.

PLoS One. 2012;7(12):e52893. doi: 10.1371/journal.pone.0052893. Epub 2012 Dec 27. Incidence and risk factors for placenta accreta/increta/percreta in the UK: a national case-control study. Fitzpatrick KE, Sellers S, Spark P, Kurinczuk JJ, Brocklehurst P, Knight M. PMID: 23300807

...METHODS: A national case-control study using the UK Obstetric Surveillance System was undertaken, including 134 women diagnosed with placenta accreta/increta/percreta between May 2010 and April 2011 and 256 control women. RESULTS: The estimated incidence of placenta accreta/increta/percreta was 1.7 per 10,000 maternities overall; 577 per 10,000 in women with both a previous caesarean delivery and placenta praevia. Women who had a previous caesarean delivery (adjusted odds ratio (aOR) 14.41, 95%CI 5.63-36.85), other previous uterine surgery (aOR 3.40, 95%CI 1.30-8.91), an IVF pregnancy (aOR 32.13, 95%CI 2.03-509.23) and placenta praevia diagnosed antepartum (aOR 65.02, 95%CI 16.58-254.96) had raised odds of having placenta accreta/increta/percreta. There was also a raised odds of placenta accreta/increta/percreta associated with older maternal age in women without a previous caesarean delivery (aOR 1.30, 95%CI 1.13-1.50 for every one year increase in age). CONCLUSIONS: Women with both a prior caesarean delivery and placenta praevia have a high incidence of placenta accreta/increta/percreta. There is a need to maintain a high index of suspicion of abnormal placental invasion in such women and preparations for delivery should be made accordingly.

Acta Obstet Gynecol Scand. 2013 Apr;92(4):457-60. doi: 10.1111/aogs.12080. Placenta accreta: incidence and risk factors in an area with a particularly high rate of cesarean section. Morlando M, Sarno L, Napolitano R, Capone A, Tessitore G, Maruotti GM, Martinelli P. PMID: 23347183

Placenta accreta is a rare and potentially life-threatening complication of pregnancy characterized by abnormal adherence of the placenta to the uterine wall. A previously scarred uterus or an abnormal site of placentation in the lower segment is a major risk factor. The aim of this study was to investigate the change in the incidence of placenta accreta and associated risk factors along four decades, from the 1970s to 2000s, in a tertiary south Italian center. We analyzed all cases of placenta accreta in a sample triennium for each decade. The incidence increased from 0.12% during the 1970s, to 0.31% during the 2000s. During the same period, cesarean section rates increased from 17 to 64%. Prior cesarean section was the only risk factor showing a significant concomitant rise. Our results reinforce cesarean section as the most significant predisposing condition for placenta accreta.

Placenta. 2012 Apr;33(4):244-51. doi: 10.1016/j.placenta.2011.11.010. Epub 2012 Jan 28. Placenta accreta: pathogenesis of a 20th century iatrogenic uterine disease. Jauniaux E, Jurkovic D. PMID: 22284667

Placenta accreta refers to different grades of abnormal placental attachment to the uterine wall, which are characterised by invasion of trophoblast into the myometrium. Placenta accreta has only been described and studied by pathologists for less than a century. The fact that the first detailed description of a placenta accreta happened within a couple of decades of major changes in the caesarean surgical techniques is highly suggestive of a direct relationship between prior uterine surgery and abnormal placenta adherence. Several concepts have been proposed to explain the abnormal placentation in placenta accreta including a primary defect of the trophoblast function, a secondary basalis defect due to a failure of normal decidualization and more recently an abnormal vascularisation and tissue oxygenation of the scar area. The vast majority of placenta accreta are found in women presenting with a previous history of caesarean section and a placenta praevia. Recent epidemiological studies have also found that the strongest risk factor for placenta praevia is a prior caesarean section suggesting that a failure of decidualization in the area of a previous uterine scar can have an impact on both implantation and placentation. Ultrasound studies of uterine caesarean section scar have shown that large and deep myometrial defects are often associated with absence of re-epithelialisation of the scar area. These findings support the concept of a primary deciduo-myometrium defect in placenta accreta, exposing the myometrium and its vasculature below the junctional zone to the migrating trophoblast. The loss of this normal plane of cleavage and the excessive vascular remodelling of the radial and arcuate arteries can explain the in-vivo findings and the clinical consequence of placenta accreta. Overall these data support the concept that abnormal decidualization and trophoblastic changes of the placental bed in placenta accreta are secondary to the uterine scar and thus entirely iatrogenic.

Placental Abruption and Prior Cesarean

Am J Perinatol. 2007 May;24(5):299-305. Epub 2007 May 18. Predicting placental abruption and previa in women with a previous cesarean delivery. Odibo AO, Cahill AG, Stamilio DM, Stevens EJ, Peipert JF, Macones GA. PMID: 17514600

The purpose of this study was to determine if placental abruption or previa in women with a history of a prior cesarean delivery (CD) can be predicted. A retrospective cohort study of pregnant women with previous CD was conducted in 17 centers between 1996 and 2000. Women developing placenta previa or abruption in the subsequent pregnancy were compared with those without these complications...Among 25,076 women with prior CD, there were 361 (15 per 1000 births) with placenta previa and 309 (13 per 1000 births) with abruption. The significant risk factors for these complications include advanced maternal age, Asian race, increased parity, illicit drug use, history of spontaneous abortion, and three or more prior cesarean deliveries. Prediction models for abruption and previa had poor sensitivity (12% and 13% for abruption and previa, respectively). In women with at least one prior cesarean delivery, the risk factors for placental previa and abruption can be identified. However, prediction models combining these risk factors were too inefficient to be useful.

Obstet Gynecol. 2006 Apr;107(4):771-8. Previous cesarean delivery and risks of placenta previa and placental abruption. Getahun D, Oyelese Y, Salihu HM, Ananth CV. PMID: 16582111

...METHODS: A retrospective cohort study of first 2 (n = 156,475) and first 3 (n = 31,102) consecutive singleton pregnancies using the 1989-1997 Missouri longitudinally linked data were performed. Relative risk (RR) was used to quantify the associations between cesarean delivery and risks of previa and abruption in subsequent pregnancies, after adjusting for several confounders. RESULTS: Rates of previa and abruption were 4.4 (n = 694) and 7.9 (n = 1,243) per 1,000 births, respectively. The pregnancy after a cesarean delivery was associated with increased risk of previa (0.63%) compared with a vaginal delivery (0.38%, RR 1.5, 95% confidence interval [CI] 1.3-1.8). Cesarean delivery in the first and second births conferred a two-fold increased risk of previa in the third pregnancy (RR 2.0, 95% CI 1.3-3.0) compared with first two vaginal deliveries. Women with a cesarean first birth were more likely to have an abruption in the second pregnancy (0.95%) compared with women who had a vaginal first birth (0.74%, RR 1.3, 95% CI 1.2-1.5). Two consecutive cesarean deliveries were associated with a 30% increased risk of abruption in the third pregnancy (RR 1.3, 95% CI 1.0-1.8). A second pregnancy within a year after a cesarean delivery was associated with increased risks of previa (RR 1.7, 95% CI 0.9-3.1) and abruption (RR 1.5, 95% CI 1.1-2.3). CONCLUSION: A cesarean first birth is associated with increased risks of previa and abruption in the second pregnancy. There is a dose-response pattern in the risk of previa, with increasing number of prior cesarean deliveries. A short interpregnancy interval is associated with increased risks of previa and abruption.

BJOG. 2007 May;114(5):609-13. Epub 2007 Mar 12. Association of caesarean delivery for first birth with placenta praevia and placental abruption in second pregnancy. Yang Q, Wen SW, Oppenheimer L, Chen XK, Black D, Gao J, Walker MC. PMID: 17355267

...SETTING: Linked birth and infant mortality database of the USA between 1995 and 2000. POPULATION: A total of 5,146,742 singleton second pregnancies were available for the final analysis after excluding missing information...RESULTS: Placenta praevia was recorded in 4.4 per 1000 second-birth singletons whose first births delivered by caesarean section and 2.7 per 1000 second-birth singletons whose first births delivered vaginally. About 6.8 per 1000 births were complicated with placental abruption in second-birth singletons whose first births delivered by caesarean section and 4.8 per 1000 birth in second-birth singletons whose first births delivered vaginally. The adjusted odds ratio (95% CIs) of previous caesarean section for placenta praevia in following second pregnancies was 1.47 (1.41, 1.52) after controlling for maternal age, race, education, marital status, maternal drinking and smoking during pregnancy, adequacy of prenatal care, and fetal gender. The corresponding figure for placental abruption was 1.40 (1.36, 1.45). CONCLUSION: Caesarean section for first live birth is associated with a 47% increased risk of placenta praevia and 40% increased risk of placental abruption in second pregnancy with a singleton.

Risks of Multiple Repeat Cesareans

Am J Obstet Gynecol. 2011 Dec;205(6 Suppl):S2-10. doi: 10.1016/j.ajog.2011.09.028. Epub 2011 Oct 6. Long-term maternal morbidity associated with repeat cesarean delivery. Clark EA, Silver RM. PMID: 22114995

Concern regarding the association between cesarean delivery and long-term maternal morbidity is growing as the rate of cesarean delivery continues to increase. Observational evidence suggests that the risk of morbidity increases with increasing number of cesarean deliveries. The dominant maternal risk in subsequent pregnancies is placenta accreta spectrum disorder and its associated complications. A history of multiple cesarean deliveries is the major risk factor for this condition. Pregnancies following cesarean delivery also have increased risk for other types of abnormal placentation, reduced fetal growth, preterm birth, and possibly stillbirth. Chronic maternal morbidities associated with cesarean delivery include pelvic pain and adhesions. Adverse reproductive effects may include decreased fertility and increased risk of spontaneous abortion and ectopic pregnancy. Clinicians and patients need to be aware of the long-term risks associated with cesarean delivery so that they can be considered when determining the method of delivery for first and subsequent births.

BJOG. 2013 Jan;120(1):85-91. doi: 10.1111/1471-0528.12010. Epub 2012 Oct 24.
Multiple repeat caesarean section in the UK: incidence and consequences to mother and child. A national, prospective, cohort study. Cook JR, Jarvis S, Knight M, Dhanjal MK. PMID: 23095012

...SETTING: All UK hospitals with consultant-led maternity units. POPULATION: Ninety-four women having their fifth or greater MRCS between January 2009 and December 2009, and 175 comparison women having their second to fourth caesarean section...RESULTS:...Women with MRCS had significantly more major obstetric haemorrhages (>1500 ml) (aOR, 18.6; 95% CI, 3.89-88.8), visceral damage (aOR, 17.6; 95% CI, 1.85-167.1) and critical care admissions (aOR, 15.5; 95% CI, 3.16-76.0), than women with lower order repeat caesarean sections. These risks were greatest in the 18% of women with MRCS who also had placenta praevia or accreta. Neonates of mothers having MRCS were significantly more likely to be born prior to 37 weeks of gestation (OR, 6.15; 95% CI, 2.56-15.78) and therefore had higher rates of complications and admissions. CONCLUSIONS: MRCS is associated with greater maternal and neonatal morbidity than fewer caesarean sections. The associated maternal morbidity is largely secondary to placenta praevia and accreta, whereas higher rates of preterm delivery are most likely a response to antepartum haemorrhage.

Semin Perinatol. 2012 Oct;36(5):315-23. doi: 10.1053/j.semperi.2012.04.013. Implications of the first cesarean: perinatal and future reproductive health and subsequent cesareans, placentation issues, uterine rupture risk, morbidity, and mortality. Silver RM. PMID: 23009962

Rates of cesarean delivery have substantially increased worldwide during the past 30 years. Indeed, almost one-third of deliveries in the United States are cesareans. Most cesareans are safe, and major complications are uncommon. However, there is a "concealed" downside to cesarean deliveries. There are rare but life-threatening morbidities that may occur, which are often overlooked because most cesareans go well. In addition, subsequent pregnancies are fraught with an increased risk of both maternal and fetal complications. The worst of these are associated with placental problems such as previa, abruption, and accreta. The risk dramatically worsens in patients with multiple repeat cesarean deliveries. This article will summarize and highlight the implications of the rising cesarean rate on maternal and fetal morbidity and mortality.

Am J Obstet Gynecol. 2011 Sep;205(3):262.e1-8. doi: 10.1016/j.ajog.2011.06.035. Epub 2011 Jun 15. Impact of multiple cesarean deliveries on maternal morbidity: a systematic review. Marshall NE, Fu R, Guise JM. PMID: 22071057

...RESULTS: Twenty-one studies (2,282,922 deliveries) were included. The rate of hysterectomy, blood transfusions, adhesions, and surgical injury all increased with increasing number of cesarean deliveries. The incidence of placenta previa increased from 10/1000 deliveries with 1 previous cesarean delivery to 28/1000 with ≥3 cesarean deliveries. Compared with women with previa and no previous cesarean delivery, women with previa and ≥3 cesarean deliveries had a statistically significant increased risk of accreta (3.3-4% vs 50-67%), hysterectomy (0.7-4% vs 50-67%), and composite maternal morbidity (15% vs 83%; odds ratio, 33.6; 95% confidence interval, 14.6-77.4). CONCLUSION: Serious maternal morbidity progressively increased as the number of previous cesarean deliveries increased.

Obstet Gynecol. 2013 Apr;121(4):789-97. doi: 10.1097/AOG.0b013e3182878b43. Consequences of a primary elective cesarean delivery across the reproductive life. Miller ES, Hahn K, Grobman WA; Society for Maternal-Fetal Medicine Health Policy Committee. PMID: 23635679

OBJECTIVE: To estimate cumulative risks of morbidity associated with the choice of elective cesarean delivery for a first delivery. METHODS: A decision analytic model was designed to compare major adverse outcomes across a woman's reproductive life associated with the choice of elective cesarean delivery compared with a trial of labor at a first delivery. Maternal outcomes assessed included maternal transfusion, hysterectomy, thromboembolism, operative injury, and death. Neonatal outcomes assessed included cerebral palsy and permanent brachial plexus palsy in the offspring. RESULTS: Choosing an initial cesarean delivery resulted in a 0.3% increased risk of a major adverse maternal outcome in the first pregnancy. In each subsequent pregnancy, the difference in composite maternal morbidity increased such that by the fourth pregnancy, the cumulative risk of a major adverse maternal outcome was nearly 10% in the elective primary cesarean delivery group, three times higher than women who initially underwent a trial of labor. Although the choice of an initial cesarean delivery resulted in 2.4 and 0.41 fewer cases of cerebral palsy and brachial plexus palsy, respectively, per 10,000 women in the first pregnancy, by a fourth pregnancy, the risk of a adverse neonatal outcome was higher among offspring of women who had chosen the initial elective cesarean delivery (0.368% compared with 0.363%). CONCLUSION: Maternal morbidity associated with the choice of primary elective cesarean delivery increases in each subsequent pregnancy and is greater in magnitude than that associated with the choice of a trial of labor. These increased risks are not offset by a substantive reduction in the risk of neonatal morbidity.

Gastric bypass for sleep trouble

2013-05-16T15:34:09Z

Anon. writes:
I was feeling unusually tired and out of energy. My GP told me to diet and exercise, and take iron supplements. I tried this for months, but it wasn’t making much difference. I talked about it with my mom, and she told me she has sleep apnoea. She asked if I had considered this. I am a snorer and being overweight can make sleep apnoea more likely, so I thought this might be the problem. So I finally went back to my GP and got a referral to a sleep clinic.

After an assessment, I got to do a sleep study where I’m monitored throughout the night to see if I stop breathing. I talked to the doctor in the morning after the sleep study. It turns out I didn’t stop breathing in the night so they could rule out sleep apnoea, but he said he thought my weight could still be keeping my energy down.

So I asked him “If it’s not sleep apnoea, then how could my weight be affecting my energy the past few months when I’ve been this size most of my life?” He said he didn’t know, but people who lose weight usually “just feel better.” I told him that I have been making an effort; I had been restricting my calories to lose one pound a week and lost 10 pounds. He said that little amount of weight loss was unlikely to make much of a difference, and often after diets people just “balloon back”. He asked if I would like to be referred for a gastric bypass. I was shocked, and told him I thought that was a serious decision and it’s not one I would take so lightly.

At the time of the sleep study, I had a BMI of 36. I’ve lost another 10 pounds I’ve lost since then, and I have moved me from the “morbidly obese” BMI category to the “obese” category. It’s a challenge, but I’m still losing slowly and healthily. No gastric bypass required, thank you very much. Oh and it turns out the tiredness was due to seasonal affective disorder. I’ve got a sunlamp and vitamin D supplements and have since been feeling much better.

Temporary Post Used For Theme Detection (f2fef263-3170-46be-90e4-62fbfdaf2407 – 3bfe001a-32de-4114-a6b4-4005b770f6d7)

2013-05-16T15:24:27Z

This is a temporary post that was not deleted. Please delete this manually. (c5228e8a-ff9a-4837-9947-9fca1bfbe48a – 3bfe001a-32de-4114-a6b4-4005b770f6d7)

Adipositivity 606

2013-05-15T00:00:00Z

On Subversion and White Women.

2013-05-14T22:10:00Z

Every few months or so some company (most recently Dove) or lady rag (Glamour, Cosmo whomever) decides that they are going to be the Captain Save A Hos of the universe. Last year I talked about Lady Gaga being the face of a new body love revolution and why it pissed me off.

Right now I've read about ten to fifteen articles around the internet where Thin Pretty White Ladies are extolling the virtues of body love and acceptance in the form of pointing out their "flaws" and using the language of self help books everywhere. LOOK AT ME I HAVE A FAT ON MY ASS AND I OVERCAME.

Etc. Etc. You've seen it.

I remain unimpressed.

I've seen a lot of arty farty things on tumblr and elsewhere that use the language of subverting the dominance of the Thin Pretty White Lady with more Thin Pretty White Ladies, but maybe they don't have on obvious make up or they are making stupid faces.

WOOHOO...

or not.

Here's the thing.

Subversion at it's root is not just putting an "ugly" face on the predominant beauties and calling it done.

In this context all that does is frankly piss off a lot of people who are in actuality, just by walking around in the world with their heads up are walking talking subversion.

In FA we have the same problem.

The hourglass beautiful White lady with big tits, a big booty and killer clothes is the Optimal Fatty.

Honestly, a lot of those people who are heralded in FA circles aren't saying anything all that deep beyond You Go Girl style feminism.

On one hand yes it's nice to see a glamourous fat person doing some glam things but, at what point do we start saying okay this is not really doing it and this person does not represent us or me at all.

My problem with this phenomenon in both FA specifically and in the world at large revolves around the absolute fact that I am not and never will be close to the Thin White Lady ideal.

I won't.

Most of you won't.

Furthermore, those of us who are far away from that idea have been doing this work for a long time. I am not here for people who whether willfully or not steal my work and the work of people like me.

I am not okay with the Thin Pretty White Ladies leading the charge against discrimination that let's face it, in the US they don't experience on a wide scale.

If we take the example of the Thin Pretty White Lady and her bit of fat on her ass, let's put her in the world of a fat person.

This is touching again on the differences between interpersonal problems (name calling, body policing etc) and institutional bias.

In this context I would like to know if that jiggly saddlebag on the thigh or the small protuberance of a bloated belly has ever caused this Thin Pretty White Lady to be denied, flat out denied basic medical care?

Generally speaking, that doesn't happen.

As I pointed out in the follow up to the interpersonal vs industrial yes it can happen but it is not the norm.

The fact is that what these (most often, and used loosely per usual) women are fighting is not in fact the soul crushing, life destroying status quo.

Most often they want how pretty and awesome they are to be reinforced.

That has nothing to do with getting me, or other fat marginalized people the things that matter. No I dont' give a fuck about Abercrombie not serving the plus size market. We KNOW they don't, have y'all looked at their websites and choices of models? come on now.

The Thin Pretty White Lady LOOK HOW PRETTY WE ARE AND WE TOTALLY DON'T GIVE A FUCK body acceptance is not what the rest of us need.

What we need is to destroy the Thin Pretty White Lady Ideal as an aspirational goal.

We need access to the basic health care that many of us pay for out of pocket, so we can live the best lives we can.

We need for those who do cater to plus size customers in terms of clothing to understand that no we don't want the worst multi animal print muumuu they can come up with. We want choices that range from couture to 19.99 pants.

We need for those Thin Pretty White ladies to yell as loud when it comes to how we are treated as they expect for us to yell about how they are treated.

We need for the Thin Pretty White Ladies to instead of taking the mic and running with it to say, hey these people know their shit listen to them.

We need for the people who believe themselves to be bucking the system by feeding us images of the current acceptable ideas of beauty and personhood to shut the entire fuck up.

We need to stand up for ourselves and our voices.

We need to not just accept the rah rah look how pretty someone is and understand that while it might feel good (if you fall into the closer to the Thin Pretty White lady Ideal than not) for a minute, it's not sustaining.

We need to look at ourselves and say, does this serve my needs?

What is my solution?

Fuck pretty. Fuck rah rah lady rag articles. Fuck Thin (or not so thin) Pretty White Ladies being the face of my needs.

I walk around in this fat Black body that is often loathed and desired, I walk around with my head up and I survive. I come here and i write stuff. I support my friends of Color and my Queers and the people whose voices tend to be drowned out in the noise of the misplaced authority of the Pretty White Ladies.

On the small scale I wear whatever the fuck I want.

I take damn fine care of myself as I can because I have to.

I survive.

My survival and the fact that I am talking to you right now is a big ole middle finger to a world that tells me constantly from all angles that I am not only not good enough but that I will never be good enough.

I open my big mouth and I talk. Or I use my silence as a weapon.

So no I'm not excited when I see a lot of the buzz or hype around acceptance because it's not for me, it's not for you and that's fucking bullshit.

Homo Out.

If you are seeing this post anywhere other than http://blog.nudemuse.org or via a feed reader it has been stolen.

The Dose Makes The Poison

2013-05-14T18:54:55Z

[A study], published in 2011, followed 28,800 subjects with high blood pressure aged 55 and older for 4.7 years and analyzed their sodium consumption by urinalysis. The researchers reported that the risks of heart attacks, strokes, congestive heart failure and death from heart disease increased significantly for those consuming more than 7,000 milligrams of sodium a day and for those consuming less than 3,000 milligrams of sodium a day.

— Gina Kolata in the NY Times

Wow, it’s almost like the extreme might be the problem. Sometimes “the dose makes the poison” is worth remembering.

Filed under: health, WellnessIndustry