Big Fat Science

In 2005, the moral panic about “obesity” was ramping up, and there was big money at stake, all resting on the idea that fat kills. 

Well, Flegal’s research pulled the rug out from under those views, not only showing that fatness was associated with only 1/3 the associated deaths that previous research estimated (and even that smaller estimate can be critiqued), but also showing that being “overweight” conferred no increased risk at all, and may even be a protective factor against all-causes mortality relative to lower weight categories. 

The reaction to these results -- which have been verified over and over again in the years since and in decades of prior research -- was swift and vicious. Powerful people launched a smear campaign against Flegal and her work:

Her research became the target of an aggressive campaign that included insults, errors, misinformation, social media posts, behind-the-scenes gossip and maneuvers, and complaints to her employer. The goal appeared to be to undermine and discredit her work.

Flegal’s first-hand account of her experience illustrates how power and stigma pervade and bias weight science. This can have a chilling effect:

One of the effects of the public insults may also have been to deter or intimidate other investigators. An anonymous researcher was quoted elsewhere as saying if character assassination is the price for publishing data that contradicts established beliefs, fewer academics will be willing to stick out their necks and offer up fresh thinking.

On October 24, Amanda Martinez Beck of Longview, Texas, told her husband: “You need to take me to the ER.” Their whole family had tested positive for Covid-19 a week earlier — Beck’s husband, Zachary, is an English professor and their best guess is that he brought the virus home from campus, or that Beck picked it up at the community pool where she sometimes swims. Within a few days, Zachary and their four children were all on the mend. But despite prescription albuterol, steroids, and antibiotics, Beck was still coughing and sleeping in a recliner at night because staying upright made it easier to breathe. Around 10 a.m. that Saturday morning, her blood oxygen level was just 92%. (A healthy adult should measure close to 100.) Beck packed a bag and Zachary drove her to their nearest emergency room. He couldn’t stay; the Becks’ children are ages four, five, seven, and eight, and they couldn’t call a babysitter since the family was still in quarantine. So Beck kissed them all goodbye, trying not to panic. “My husband thought he was never going to see me again,” she says now.

Did you know that chronic dieting and disordered eating can damage your digestive tract? Leading to delayed stomach emptying and slow digestion, resulting in chronic acid reflux and indigestion because food stays in the stomach too long? Often, these and other similar kinds of digestive problems are called functional gastrointestinal (GI) disorders. That means that there is a problem with digestion that is not caused by injury or obvious disease of the digestive tract. 

Fully 97% of people who are diagnosed with restrictive eating disorders have functional GI disorders, and about 40-50% of people who are diagnosed with a functional GI disorder have a history of disordered eating or chronic dieting. 

Often these disorders emerge during recovery when eating adequately and regularly stresses a digestive system that is damaged and slow from years of abuse and misuse. As I have said before, consuming less energy than you need to survive causes catabolism -- basically, your body starts breaking down muscle for energy, and that includes the muscles of the digestive tract. Starvation can also damage the nerves that co-ordinate digestion, including the vagus nerve (woop woop, trauama also fucks up the vagus nerve!).

So when I hear that someone is in recovery from restrictive eating and dealing with chronic reflux or other digestive complaints, my first thought is that those two things are related. 

What can people do about it? 

See your doctor and get evaluated and tested, and get a prescription for acid control medications to relieve your symptoms. It’s NOT your fault. You deserve to have relief. 

Work with a non-diet dietitian to help normalize your eating, which in turn can heal and regulate digestion. Eating regularly and adequately can help to heal the digestive tract. 

Moving your body in ways that feel good can:

Stimulate digestion and appetite.

Strengthen muscles that will make all of life’s activities easier and more manageable.

Improve and support circulation, especially to extremities.

Support metabolism of blood glucose into energy (in other words, help you get lots of energy out of what you eat).

Help you fall asleep easier at night and stay asleep through the night

Help people to regulate their moods by reducing depression and anxiety

Increase positive emotions through the release of endorphins

Improve cardiovascular health -- lung, heart, and blood vessel health

Decrease stress by activating the parasympathetic nervous system and by helping to “scrub” cortisol and other stress hormones from the blood stream (especially true for stretching, yoga, tai chi and similar breath-based practices)

Increase feelings of connection to your body

Produce feelings of efficacy and competence (”I did it!!”)

Reduce pain by moving lactic acid out of muscles and reducing inflammation

Wise words.

We do this with our kids, too. One year, my then five year old ate too much and got sick. Never happened again! And now I can remind him: “Go easy, listen to your body, you don’t want to get sick” and he knows what it means. My other son didn’t need that experience to learn. But every kid is different!** And now my kids love Halloween and they love trick-or-treating, but they are not obsessive and fetishistic about their candy haul. Most years, they don’t even eat it all. 

This is a huge contrast to my childhood, where I would try to eat all the candy as quickly as possible because I knew if there was any left the day or two after Halloween, my mom would take it away. The fear of losing the candy definitely spoiled the enjoyment.

Unconditional permission to eat.

All foods are good foods.

Eating something is better than nothing.

Scarfing down a handful of nuts, a slice of cheese, and a fruit cup is a meal.