4.17.2015

Rest in Power, Catherine Han Montoya

I'm off my game this week.  This is, in large part, due to the fact that social justice lost an incredible advocate this week.  I didn't know her well; I know her wife better, but still as not much more than a colleague.  Still, in the brief time I spent with her, it was immediately obvious that she was funny, loving, and full of life on top of being a compelling speaker and unceasing justice fighter.  She was lost to an unthinkable act of violence - the kind of event that reminds us that life can be taken from any of us at any time.  My heart is with her wife, her family, and her close friends, who must process this incomprehensible loss.

Many who are both more eloquent than me and who knew Cathy much better have created beautiful tributes to her life and work.  So rather than forcing you to endure more of my self-indulgence, I'll share those sentiments here.  If you are in a position to contribute to her fund, know that those monies will be used for good.
 

To know Catherine Han Montoya was to love her, because you couldn’t help but feel her love for us, for the people, and for the world.






The Leadership Conference on Civil and Human Rights
Our family lost a vibrant champion for social justice this week with the tragic death of Catherine Han Montoya. Cathy, who was killed in her home in Atlanta under circumstances that are still being investigated, was an extraordinarily talented leader and skilled organizer, and leaves a legacy of building bridges of unity and opportunity across multi-ethnic communities. We mourn her passing, and our hearts and thoughts are with Cathy’s wife, Meredith Cabell, their families, and with all of those who had the good fortune to know Cathy and to be enriched by her all-too-brief time on this Earth. http://bit.ly/1b6QXaG


National Asian Pacific American Women's Forum (NAPAWF) 
Our NAPAWF family mourns the tragic loss and celebrates the life of Catherine Han Montoya, founder of NAPAWF Atlanta, the first chapter in the American South.  Catherine, a self-described Queer Chicana Korean Feminist (& Broncos fan), was dedicated to advancing justice in API, immigrant, and LGBT communities through her work with the Southeast Immigrant Rights Network, Alabama Coalition for Immigrant Justice, ACLU, Leadership Conference for Civil & Human Rights, and National Council of La Raza.
Her life touched and inspired many. Rest in Power, Catherine Han Montoya.  "Let’s honor Cathy and step up and do our part now, and answer the call. Please donate to help support Meredith and their family. Funds will go towards helping with funeral costs and to supporting Cathy’s deepest loves: her family and the movement."



Catherine Han Montoya
1977 - 2015 | Obituary
MONTOYA, Catherine IN LOVING MEMORY Catherine Han Montoya Catherine Han Montoya passed away on Monday, April 13, 2015 in Atlanta, GA. She was born in Fort Huachuca, AZ in 1977. She attended Aurora Central High School in Aurora, CO and college at the University of Colorado at Boulder. A self-described "Queer Chicana Korean Feminist (and Denver Broncos fan)," Cathy's ability to empathize across difference moved her to dedicate her life to helping others celebrate and live wholly in their identities. Cathy became a tireless champion for civil and human rights, immigrant rights, Asian American women's rights, queer rights and racial justice. Cathy was greatly impacted by her mother's experiences as an immigrant in the U.S.

 As a teenager, she became interested in politics, and would debate fiercely with any opponent, but particularly with her father Joe. An ardent activist, she spoke truth to power with a smile and laughter, planted love in the hearts of everyone she touched and constantly challenged her family, friends and colleagues to channel their better selves. Cathy dedicated herself to working for justice, always bringing passion, humor, kindness and light to every endeavor and every relationship. She was a brilliant strategist, organizer, coalition builder and visionary who always stepped up to lend a hand.

Despite her numerous accomplishments, Cathy was humble, down to earth, and unassuming, treating everyone with deep respect, no matter what their position or experience. She was the type of person who wore sneakers to formal occasions and bow ties to weddings. She was stylish, but it was her exuberant joy and laugh that made her stand out. Cathy helped shepherd a new generation of social justice leaders and was seen as an older sister to countless activists across the US

Cathy co-founded the Southeast Immigrant Rights Network as well as the first National Asian Pacific American Women's Forum chapter in the South, and practically moved with her wife Meredith to Alabama in 2011 to help the Alabama Coalition for Immigrant Justice organize against a law - HB56 - that she believed was morally wrong. She also worked at the National Council of La Raza, the Leadership Conference for Civil & Human Rights, and the ACLU.

Cathy will always be remembered as a loving wife, daughter, sister, aunt, and friend. She leaves behind her beloved wife, Meredith Cabell; her parents, Joe Montoya and Chong Hitchens; sisters Lynnette, Jennyfer and Rebecca; nieces and nephews Valerie, Kayla, Bobby, Josh, Brandon, Peyton, Justin and Ryan; and dog, Louie. The outpouring of support and love shown for Cathy since her passing has been immense, and is a testament to the enormous impact she had on so many. Her love, light and spirit will forever fill the hearts of all those she touched. A wake will be held Saturday, April 18th, from 4pm to 8pm at and the Funeral Service will be held on Sunday, April 19th at 1 pm, both at A.S. Turner & Sons Funeral Home located at 2773 North Decatur Road, Decatur GA 30033

A memorial service will be held in Denver, CO in the coming weeks. Contributions for the family can be made at: http://www.youcaring.com/memorialfundraiser/ honor-catherine-han-montoya-s-life-legacy/337884

Published in The Atlanta Journal-Constitution on Apr. 17, 2015

4.15.2015

Is "This Is Why You're Fat" why you're fat?
Food Issues Book Club - Weighing In, Chapter 5

Hello all!  Welcome to the NOiG Food Issues Book Club, wherein I read books about food stuff, summarize each book by chapter, and then attempt to apply that book chapter's ideas to the New Orleans food environment and my own experiences.  Fun right?!  Check out previous installations here.  I'd love it if you'd read along and join in!  And now, without further ado...

Weighing In, Chapter 5: Does eating (too much) make you fat?

Summary:

The idea of "calories in, calories out" is a fallacy that fuels healthism and sizeism, and is counterproductive to a better understanding of obesity.  The so-called "energy balance" model serves to shift the matter completely to a question of personal responsibility and self-discipline, and in doing so ignores any other possible obesogenic forces.

Is it, though?
"[I]t is critical to think about the body as a site where the biological and the social constantly remake each other."  A number of alternate theories have emerged to explain the country's increasing BMIs; the frontrunner is the effects of a group of environmental toxins referred to as obesogens.  These may include pesticides, prescription drugs, and "many other substances and stressors" that result in endocrine disruption.  So-called Endocrine disrupting chemicals (EDCs) "can interfere with genetic expression in ways that permanently transform bodily form and function, and these changes can be passed on to offspring.  Epigenetics could thus account for the genetic contribution to the abrupt increase in obesity."

While typical toxicology looks at dose-response, the toxicity of EDCs is not directly proportional to dose; moderate doses can have the worst effects.  The timing of exposure also strongly informs effects.  And to further complicate matters, genetic variability can make different people more or less susceptible to the effects of an EDC even when all other variables are constant.  Finally, the effects of EDCs can be delayed for years or decades - or even generations, as is the case with synthetic estrogen prescribed to pregnant women in the 1950s.

The main culprit seems to be EDCs that affect estrogen, a hormone found in both men and women.  EDCs that affect estrogen seem to be able to suppress or stimulate fat accumulation, depending on the timing of exposure and the sex of the person exposed.  These EDCs may come in the form of medicines, food additives, and various types of food and beverage packagings.

The "probable effects" of EDCs are "significant and lasting, and can work independent of caloric intake and expenditure."  Numerous EDCs are found at every stage of food production, processing, and sale.  It is foolish, then, to ignore how "various food substances affect bodily ecologies" both in adiposity and in other possible ways.  "Putting all of the evidence together creates a strong case that the increase in size is not all about soda, fries, and video games."  While overeating or eating poor quality foods may be one factor in increased body size, ignoring the many other possible influences renders us incapable of viewing increased obesity from a full food system perspective.

Random awesome internet image
Discussion:

I'd like to start here by eating some metaphorical crow.  I wouldn't eat real crow.  Y'all know I'm vegan.  Anyway, I used to be a "calories in, calories out" person - and not that long ago either.  I'd preach it on the internet and in real life to anyone who'd listen.  The math made sense!  I was in control!  I used it to make charts and graphs of how many calories I'd taken in vs. how many I'd burned.  I also used it to feel bad about myself when I slipped up and ate too much - or worse yet, when after all my counting and measuring and expending, I didn't lose a single damn pound.  If it's not working for you, you're not trying hard enough, amirite?!  You'll be healed if you truly believe; so says the Church of Healthism.

If I ever directed this nonsense at YOU, dear reader, I wholeheartedly apologize.  Please forgive me.  I could not have been more wrong.

Good ol' CiCo does seem to make sense on its face.  It's based on the laws of thermodynamics!  It's SCIENCE!  (Sure it is... except that the laws of thermodynamics are profoundly misunderstood by the general public and don't apply to bodies this way.)  So then, why could it be that so many people eat well and exercise and don't lose weight?  And so many other people eat so poorly and don't exercise at all and remain svelte?  Could it be that - GASP! - there's something going on here that's beyond our personal control?  We all want to be in control of our lives and our bodies.  And the Powers That Be certainly want to be able to direct all blame at us, the individuals.  The reality, though, is that many things are out of our hands (and mouths) - and that often includes our weights.

BEWARE!  They say it dissolves ANYTHING.
Now, to the text.  I want to point out that the summaries of this book's chapters are vastly simplified from the original text.  This is a highly academic work with easily 3 to 6 cites to peer-reviewed articles on each page.  Which is to say that Guthman is not making this stuff up; she is reviewing credible science and drawing reasonable conclusions.  She is not wildly pointing fingers at "scary chemicals" as the source of all our woes, like some more... ahem... popular and visible folks are fond of doing.  I assure you that this author is interested only in real science.  To that end, she admits that "this research is in its infancy" and does not answer all of the questions we have about what causes unwanted weight gain.  If nothing else, though, the research indicates that the picture is much bigger that what people eat vs. how much they exercise - which means that as long as that's the only aspect we're looking at, we won't ever find answers as to what's happening.

For some added credibility, here are several of the articles cited in this chapter (all links to articles are full text).  Be warned, vegan / AR friends - these studies depend heavily on animal testing.
And one book:

If you're still clinging to the "calories in, calories out" theory, not to mention the idea that being fat is a crisis-level situation that must be rectified at any cost, ask yourself these questions:
  1. Who truly benefits from these beliefs?  Is it the people who remain overweight because now they have an "excuse" (yet often feel terrible about themselves and/or are constantly being told that their bodies are wrong)?  Or is it the insurance companies who refuse to cover treatment for obesity, and/or the food companies who spend billions marketing "healthy" foods with specious health claims to us, and/or a variety of other rich and powerful entities that make more money when people behave according to these beliefs?

  2. Do you really believe that over a third of the adults in the US - more than 1 out of every 3 people you know (and 7 out of 10 if you're counting just overweight) - are just SO lazy and irresponsible that they could be a "normal" weight and choose to remain obese despite it being soooooo unhealthy (crisis!) and despite it being soooooo simple to lose weight?
Personally, based on experience, observation, anecdote, scientific data, and a million pieces of information in between, I think it's clear that, though food choices do obviously affect weight and health, the picture is far more complicated than the dominant paradigm would like us to believe.

4.12.2015

Shake for your &@#!ing hood if it's all good
Food Issues Book Club - Weighing In, Chapter 4

Hello all!  Welcome to the NOiG Food Issues Book Club, wherein I read books about food stuff, summarize each book by chapter, and then attempt to apply that book chapter's ideas to the New Orleans food environment and my own experiences.  Fun right?!  Check out previous installations here.  I'd love it if you'd read along and join in!  And now, without further ado...

Weighing In, Chapter 4: Does your neighborhood make you fat?

Summary:

There is a prominent theory which proposes that "people are fat because they are surrounded by cheap, fast, nutritionally inferior food and a built environment that discourages physical activity," also known as an obesogenic environment.  While positive in that this school of thought seems to take aim at something other than personal responsibility, the idea of the "obesogenic environment" can reinforce healthism.

Studies of the obesogenic model presume that obesity is solely the result of excess caloric intake - the much embraced yet vastly oversimplified "calories in calories out" model.  It also implies that people living in obesogenic landscapes are only affected by it, rather than considering the ways in which they may interact with or mitigate its effects.

These studies also tend to be severely restricted by the narrowness of data types used: "many possible explanations of geographic variation in obesity are not explored, whether cultural, economic, or environmental."  These types of data may not be used due to difficulty in collection.  Other data though, such as those on unemployment, housing, and educational opportunity also go unused - likely because "they don't fit existing assumptions about what causes obesity."  In this way, a true examination of the causes of obesity is precluded by studies designed with a cause presupposed.

Both dense urban centers with little access to groceries and low walkability, as well as sprawling suburban neighborhoods that foster dependence on cars, have been pegged as obesogenic.  However, what if cause and effect have been reversed?  "Contemporary geographers emphasize that spatial patterns in housing, commercial development, and public land access are a reflection of social relations of race and class rather an a producer of them...  what may be 'predicting' the prevalence of obesity in certain places is in fact race and class... with features of the built environment being an effect of that spatial patterning rather than a cause."

People who live in either of the two types of obesogenic environments likely do so due to financial concerns - they cannot afford to live in areas that are more conducive to eating well and exercising outdoors frequently.  In short, leptogenic (thin-making) environments are only available to the privileged.  It is more appropriate, then, to state that both obesity and living environment are reflections of class status, which itself is too often informed by race.  "[I]f the idealized "leptogenic" environment is one of privilege, there are limits to how much we can redress the obesogenic environment without confronting class and racial inequality."

So far, attempts to address obesogenic environments have focused on actions such as incentivizing grocery stores to open in "food deserts." These supply-sided interventions are based on the belief that the mere presence of "better" offerings will create "better" behaviors and relieve obesity - a sort of "if you build it they will come" theory.  Such efforts, though, can have the unintended effect of pushing people of fewer means - often people of color - out of the areas that have suddenly become attractive to the more privileged.  Instead of creating a less obesogenic environment for the underprivileged, these efforts can instead open a door to gentrification. 

Discussion:

If you build it, "they" will indeed come.  "They" just aren't the intended audience.

The Whole Foods that opened last year on Broad Street had the very best of intentions - well, beyond the intention of every for-profit business of turning a profit.  It was put in the abandoned Schwegmann's as part of a broader effort to revitalize a low-income neighborhood that has become increasingly more blighted since Katrina, and specifically to provide more fresh food and health education to the area.  But you know what they say about good intentions.

I live in Mid-City, and I shop at this new Whole Foods that's less than a mile from my house.  It wasn't there when we moved in.  Since then - the summer of 2012 - area housing prices have gone up, and not slowly.  And yes, I know that we are part of the problem.  As my husband likes to say about us, "here comes the neighborhood!"

This is what really sucks about gentrification - so often, it's unintentional.  Some middle-class white folks like ourselves find a house in a neighborhood predominately populated by lower-income people of color, not in any effort or desire to displace them, but because we've been priced out of any neighborhood not meeting that description.  Once more affluent families start moving in, businesses catering to more affluent households follow.  Soon, housing prices increase - what with all those new amenities close by, why wouldn't landlords and real estate investors take advantage?  In short order, that neighborhood that used to be populated with the working class is full of the more privileged, and the marginalized are pushed even further away from those features that were meant to "fix" their health problems.  Of course, those great features don't help the people who can no longer afford to live near them.  And so, the cycle continues.

To its credit, the so-called ReFresh Project in which Whole Foods is housed does have some other benefits for the immediate community.  Tenants include:
  • Liberty’s Kitchen, providing culinary work readiness and leadership skills training for at-risk youth (and also serving pretty great vegan red beans and rice as well as a tasty black bean burger);
  • Goldring Center for Culinary Medicine at Tulane University;
  • FirstLine Schools' central offices (of debatable utility, but they do offer Edible Schoolyard programs at all of their schools);
  • Boystown center for children and families;
  • Broad Community Connections offices;
  • Crescent City Community Land Trust offices;
  • AND an on-site teaching farm in partnership with SPROUT NOLA, Harambee Gardens of New Orleans, and Faubourg Farms which works with students and the community to teach hands-on vegetable growing skills
In addition to Whole Foods / ReFresh, the Mid-City Lafitte Greenway is endeavoring to improve the neighborhood's walkability and create exercise opportunities.  Scheduled to open early this summer, the only direct effect I've witnessed thus far is that the makeshift foot bridge over the canal at N. Lopez and St. Louis has been fenced off, forcing those who walk or ride bikes to travel several blocks out of the way to Jeff Davis Parkway to pass.  So... I guess they're getting more exercise?  They'll be fit in no time, no doubt!  (Please sense my sarcasm.)  Really though, I'm sure my husband and I will use this pathway.  I fear, though, that it will cause housing prices along the entire swath to rise even more quickly.

I don't know who is to "blame" for this process, though I'm compelled to lay more blame at the feet of corporations and city planners than at those of individual homeowners... and that could be just because I am one.  Certainly at issue are the underlying problems of systemic racism and classism that still shape so much of American culture, and seem most troublesome here in the South.  Even I, with all my privilege, am powerless in this process.  I can only hope that the people who were living in the neighborhood before all us privilege folks started to roll in do not get pushed out - or that they at least get to take advantage of some of the "better" amenities before their ousting.

To the initial chapter question "does your neighborhood make you fat?" my answer, for now, is a solid maybe.  I think that for some people, under some circumstances, an "obesogenic environment" could be one of the contributing factors to adiposity.  However, it is folly to look at such a complex issue from just one perspective; rather, I believe it's crucial that we look at the complete set of biological, psychological, environmental, and social factors that affect an individual in determining that individual's situation.

And now, because there was an implicit promise in the blog post title and because I freaking LOVE this song (and don't worry, it's the safe-for-work version):


4.09.2015

I just don't think that's my problem.
Food Issues Book Club - Weighing In, Chapter 3

Hello all!  Welcome to the NOiG Food Issues Book Club, wherein I read books about food stuff, summarize each book by chapter, and then attempt to apply that book chapter's ideas to the New Orleans food environment and my own experiences.  Fun right?!  Check out previous installations here.  I'd love it if you'd read along and join in!  And now, without further ado...

Weighing In, Chapter 3: Whose problem is obesity?

Summary:

"[I]nvoking health to talk about obesity can work against social justice."  In fact, it can create social injustice.

The idea that obesity causes increased healthcare costs for society is so commonly espoused as to have become a trope.  Figures are regularly calculated and repeated for these costs that are assumed to stem from obesity - whether or not there is any evidence that such is the case.  Such numbers assume that all ailments that might be associated with overweight are in fact caused by it.  Overweight people are thus villainized, painted as a burden for all.  Moreover, obesity is described as a "choice," the result of lack of self-control.  A failure of personal responsibility borne solely by individuals.  Lest we forget, though, "care for the sick is an economic burden only in heath care systems where profit is the bottom line and public services are underfunded and politically unsupported."

This view of obesity stems from healthism, a mentality that health is a moral imperative and the most important gauge of self-worth.  Pairing neatly with neoliberalism, healthism supports the anti-government, pro-corporate, "everything comes down to personal responsibility and opportunity and circumstance don't matter" mindset that rose to prominence in the 1980s and has yet to lose a grip on our culture.  The judgment as to whether someone conforms to the dictates of healthism is frequently - nearly always - based on the appearance of health (thinness and attractiveness) rather than any actual evidence of health.

In this framework, healthy (thin) people are moral, hard-working, and attractive.  Unhealthy (fat) people, by contrast, must be immoral, lazy, and ugly.  In short, healthism renders the obese both worthless and burdensome, a weight to bear for those who judge themselves superior.  Unsurprisingly, "healthism speaks to those who are already reasonably healthy."  These "reasonably healthy" people then feel, since fatness / unhealth has been deemed a choice and a result of laziness, that they have the right and even the duty to tell fat people to shape up.  Indeed, "those taken by healthism can display significant lack of tolerance for those who are not."  In this way, it "provides a veneer for neglect or exclusion" of all those who appear, based solely on aesthetic attributes, not to subscribe to healthism's dogma of get fit or die trying.  In this way, healthism excludes not only the overweight but also those with disabilities or with any other insurmountable barrier to obtaining visible optimum health. 

Healthism of course benefits those who do aesthetically appear to adhere to its demands - whether or not those individuals expend any effort to do so.  The naturally thin and beautiful are thus judged to be hardworking, moral, and self-disciplined regardless of the actual presence of these traits.  But healthism is bad even for people who can look the part: for those who do have to work for the look of health, it can encourage image obsession, narcissism, and even self-harm.

Healthism is bad for everyone.  To address obesity, and public health more generally, we must "think differently about health and where blame lies for health inequalities."

Discussion:

Based solely on my mother's continued reactions, the fact that I have become overweight (yes, per the uber-flawed BMI I am "obese") is literally the worst thing that has ever happened.  Ever.  Worse than my father being paralyzed.  Worse than Katrina destroying all our lives.  So, so much worse that she can barely contain herself from saying something about my appearance (not my health, mind you, my appearance) every. single. time. I. see. her.  Which in case you were wondering is about once a week.

Maybe this is some kind of karmic payback for the time when I was nine and told her that I didn't like fat people?  No, probably not.  My mother, it seems, has a lifelong paid subscription to healthism.  It's easy for her to do; for her whole life she's been effortlessly thin and petite.  She has never had an exercise regimen.  She doesn't count calories or even particularly watch what she eats (though she does stay away from the classic American trap of "junk food"... mostly).  In her eyes, she is healthy and I am not.  Never mind that she's had cancer.  Never mind that less than a year ago she literally almost died from sepsis.  Never mind that she has high cholesterol, high blood pressure, and osteopenia.  Never mind that she lives in so much chronic pain that she completely retired (from part-time, self-employed work - the only kind she ever engaged in from the time she had her first child) well before her 65th birthday.

It's clear to her that it's me - who is vegan and eats mostly whole foods, who wears a pedometer and does everything in my power to make my steps each day, who goes to the gym, who works full time and has a full social life and a successful marriage and engages in social activism, but who also happens to wear a size 18 in pants - who has the health problem.  I do have health problems, many of them.  And all of them are causes of, rather than the result of, my current weight.

What's worse, really, is that she seems to think that I'm doing this on purpose, remaining this size because I'm too stubborn or lazy to address it.  Though if that is what was happening she'd have no right to criticize it, it's simply not the case that this is a choice for me (or for many overweight people).  I'm sure that there are some people who are overweight because they eat poorly and/or are lazy, and could choose to eat differently and be more active and have the weight melt right off.  That doesn't mean that case is universal, and it also doesn't mean that anyone gets to tell them what to do with their bodies.

I have always had a large, thick frame and spent from my late teens through my early thirties wavering on the BMI line between "normal" and "overweight."  I struggled with body image, like most of the women I've ever known.  Then in 2011, a perfect storm of medication problems and stress and probably some unknown factors pushed my body to gain and retain about 60 pounds inside of a year.  I had to replace all of my clothes, and have since had to withstand CONSTANT comments on my appearance from friends, family, acquaintances, and strangers alike, including regular inquiries into "the pregnancy" (there isn't one).  YES REALLY.  ALL THE TIME.

The weight is here, and it's staying as far as I can tell.  I didn't do anything "lazy" or "undisciplined" to make it come, and I refuse to do anything unhealthy to make it go - or to apologize for my size.

As far as my social development goes, the experience has been good for me. While I was always aware of it, I've realized just how profound fat-phobia / discrimination is, and how entitled people feel to comment on, judge, and make assumptions about others' bodies and perceived behaviors.  I've discovered that if you wear higher than a size 14 but less than a 20 in women's clothing - or if god forbid you're fat but have small breasts - it's basically impossible to find clothes.  I have experienced the very ugly product of healthism that is fat shaming.  Some folks think it's actually a good thing!  A motivational tool that'll get us lazy fatties up off our asses.  I hope you all see the numerous problems with the assumptions made there.

Like all neoliberal ideals, healthism seems designed to create "haves" and "have nots," to outline an exclusive club for which many cannot ever meet the membership criteria.  Those in the club see no problem with this - despite the fact that many make themselves miserable or go to great expense to continue qualifying.  Sometimes I wonder when we are all going to WAKE UP and realize how indoctrinated we have become with ideas that benefit the few and hurt the many.  Of course, for that to happen we'd have to be happy with a club that lets anyone join.  Historically, those have always been the least popular.

In conclusion, an anecdote: While drafting this blog post I've also been engaged in an email exchange with my insurance company, which was of course trying to shaft me out of paying for some endocrinological testing.  The following exchange was had just an hour ago (verbatim from email). 
Her: I have sent the claim back to be reconsidered based on the secondary diagnosis that was filed.  The claim originally denied because the primary diagnosis was not a covered diagnosis under the plan. 

Me: I’d like to understand this – are you saying that hypoglycemia isn’t covered? 

Her: That was the secondary diagnosis that was filed, so we will reconsider based on that diagnosis.
Me:What was the primary diagnosis, obesity? 

Her: Yes
The entire country seems to think that our most pressing health problem is obesity. But just don't try to seek medical help for it unless you want to pay for it out of pocket, kay?  The best part, of course, is that's not even what I was seeking help for.  YAY AMERICA!

4.06.2015

But, do you like, *know* know?
Food Issues Book Club - Weighing In, Chapter 2

Hello all!  Welcome to the NOiG Food Issues Book Club, wherein I read books about food stuff, summarize each book by chapter, and then attempt to apply that book chapter's ideas to the New Orleans food environment and my own experiences.  Fun right?!  Check out previous installations here.  I'd love it if you'd read along and join in!  And now, without further ado...

Weighing In, Chapter 2: How do we know obesity is a problem?

Summary:

The so-called obesity epidemic has been framed "in ways that tend to overdramatize some elements and underspecify others, especially those that might lead to different conceptualizations of the problem."  The result is that we are more concerned about size (appearance) than actual presence of illness.  "The term obesity reflects a medicalization of fatness."  While this approach can open avenues to treatment, it also insists that there is in fact an illness to treat.  Even in the World Health Organization definition of obesity, there is an inference that anyone who is fatter than they "should be" is automatically ill - whether or not there is any other indication of illness.

The average national Body Mass Index (BMI) began to rise in the late 1980s, and leveled off again in the 2000s.  BMI is the most frequently used measure in studies of obesity, simply because it is the easiest to measure, requiring only a few pieces of personal information to calculate.  This measure, though, tells researchers only about the size of a person (height relative to weight) and nothing about actual healthfulness.  It is in fact not even particularly accurate at determining excessive adiposity, given that it "makes no allowances for variations in bone mass and density, or somatic differences more generally."  It also fails to account for differences in body type or fat deposition patterns.

Where do you fall?  Does it matter?
A good illustration of the problem
with BMI (if a bit fat-shaming)
Calculations of the rates of obesity based on BMI are misleading for several reasons.  Because of the absolute cutoffs used in its calculation (for instance, a BMI of 24 is normal but 25 is overweight), a person who is two pounds over the line of "obese" is reflected identically to a person 100 pounds or more over the line.  Second, in 1998, the BMI value for "overweight" was changed from 27 to 25.  As a result, millions of people went from normal to overweight without any actual change in weight.  These relatively arbitrary cutoff points are assigned meanings that are overstated, often to the point of inaccuracy.

The use of the word "epidemic" is catastrophising and even cruel, "simultaneously minimizing the violence of serious plagues and overstating the association of corpulence with death."  Determining whether fatness is a causal factor in deaths has been greatly oversimplified.  Prominent studies claiming to show higher morbidity and mortality in the obese assume that all obesity stems from poor diet and too little exercise, "letting the condition stand in for the behavior."  A 2005 study actually showed lower mortality among most categories of overweight people when compared to those of "normal" weight.  Other studies have shown an increase in mortality among the very thin.  Of course, in all cases, association does not mean causality.

The methods used to determine obesity rates and risks of associated illnesses are, then, prone to the shortcomings of all statistical analysis.  For example, those who go to doctors for treatment are more likely to be ill - and those who are willing to be studied are more likely to be healthy - than an unbiased cross-section of the population would be.  As such, studies based on information from either of these groups is a poor representation of broader trends.

"The use of size as an indicator of risk appears to be blunt at best, and possibly much more damaging."  While there is in fact an increase in body size, "[t]he issue is how we interpret these changes, how we treat them, and the consequences of both."

Discussion:

As I discussed last month, the City of New Orleans supports a fitness initiative called FitNOLA.  It aspires to a goal of becoming one of the top ten "fittest" cities in the US by 2018.  Its homepage very clearly indicates that its fitness goals relate directly (and seemingly only) to obesity: "The City of New Orleans Health Department is leading an effort designed to shape a shared vision for our own city as it addresses obesity, one of its major public health challenges... Together we can turn the tide to win the battle against obesity and create a more fit city."

But is a lack of obesity the same as presence of fitness?  I believe that answer is a resounding no.  While an association can be drawn between "normal" body weight and health for some individuals, there are overweight people who are healthy, and thin people who are quite ill.  How do we unfurl the concepts of weight and health, now that they are so intertwined in the minds of most?  This conflation reminds me of the insistence that only meat contains protein and other such nutritional fallacies.

Nola's favorite Fat(s)
New Orleans certainly hosts its fair share of people who are overweight.  And yet it also homes people who are food insecure (a lot of them), and people diagnosed with cancer, and people with addiction problems, and people of "normal" weight who suffer from diabetes and high cholesterol and hypertension.  Certainly people who are starving, dying, or drug dependent are not "fit" - even if they are thin.  Why, then, focus so exclusively on fatness?

Perhaps the city chose to focus on it because it places all responsibility - and all blame - on individuals, and deflects completely away from the city for, say, failing to make sure that all of its citizens have safe outdoor spaces in which to exercise and a non-toxic food environment and clean air.  Perhaps it's because we can look at people and know they're fat, and can't do any such thing with the other issues mentioned.  Perhaps it's just because Michelle Obama said so.

Whatever its cause, this obsession with the idea that fatness is sickness and thinness is health is both incorrect and also potentially dangerous, even beyond the inevitable psychological trauma of the fat-shaming it fuels.  Since thin people have been told that they are healthy, they may opt not to visit the doctor - why should they? - and as such miss diagnoses of potentially life-threatening illness.  Even more frightening, since doctors are also prone to the "thin is healthy" bias, they may overlook developing health problems in thin people.

To the credit of the FitNOLA program, its homepage also lists free exercise classes held each day at different parks around the city.  Attending them may or may not help you lose weight (if that's what you want to do), but getting some good exercise can make all of us more fit.  In the end, it's fitness - not fatness - that matters.  Also check out Heath at Every Size, whose name pretty much says it all.


4.03.2015

Problem? What problem?
Food Issues Book Club - Weighing In, Chapter 1

Hello all!  Welcome to the NOiG Food Issues Book Club, wherein I read books about food stuff, summarize each book by chapter, and then attempt to apply that book chapter's ideas to the New Orleans food environment and my own experiences.  Fun right?!  Check out previous installations here.  I'd love it if you'd read along and join in!  And now, without further ado...

Weighing In, Chapter 1: Introduction - What's the Problem?

Summary:

Obesity has been erroneously linked to global warming by a number of researchers in the past decade.  The connection hinges on neo-Malthusian ideas that appetite drives food production, and that hunger is a result of insufficient food production.  These notions are flatly false.  As with global climate change, solution-seekers attempt to oversimplify the problem of obesity in order to provide a simple solution: in both instances, one of personal behavior change.  And in both instances, changing or even addressing the underlying cause(s) of the problems is avoided.

To address obesity, we must understand its internal and external ecologies, and its cultural context, in addition to the roles played by corporate behavior, state regulation, and the political economy.  We must also pay attention to how information about obesity is being messaged - for instance, we must examine the connection that has been drawn between personal behavior and obesity, and the drivers of such behavior.  "To the extent that eating eating and exercise contribute to obesity, these behaviors don't happen in a vacuum of social possibility."

As humans, scientists and their work are unavoidably affected by social influences.  The ways in which issues are framed - the pathologizing of obesity, for example, as an epidemic - influences the ways in which overweight is studied and how results are perceived and presented.  "How we know health depends on how we talk about it, and how we talk about it shapes how we think about it."  Despite efforts at objectivity, scientists' preconceived notions are implanted in design study and reporting.

This book endeavors to circumnavigate the restrictions imposed by the "problem closure" of obesity: to reframe the problem in order to determine different avenues by which to address it.  "Ultimately [this book] is about the limits of capitalism.

Discussion:

For real y'all?  This first chapter blew my freaking mind.  New ideas!  New refutations of "calories in / calories out" nonsense!  In the first few somewhat autobiographical pages she a) calls herself out for being a privileged "foodie," b) calls the food issues crowd out for constantly leaving everyone who is not privileged out of the picture and/or judging them, and c) indicts the conventional food system in no uncertain terms.

Is this the book I've been waiting for?  It might just be.  Since this chapter really just touches on the subjects more thoroughly explored in later chapters, I'll leave the discussion there for now.  But I do think that it's going to be an awesome month.

Since there are no good images for "new-Malthusian ideas" or any of the other big words used liberally in this here academic work of a book, here's a picture of knitted oysters on the half shell (with cocktail sauce!) from a recent art installation that was part of the city-wide P3 event.

4.01.2015

Food Issues Book Club: April!

Hello all!  Welcome to the NOiG Food Issues Book Club, wherein I read books about food stuff, summarize each book by chapter, and then attempt to apply that book chapter's ideas to the New Orleans food environment and my own experiences.  Fun right?!  Check out previous installations here.  I'd love it if you'd read along and join in!  And now, without further ado...

New month, new book!  I seriously can't wait to dive into Weighing In: Obesity, Food Justice, and the Limits of Capitalism by Julie Guthman.  It's more recent than my last few selections (2011), and so should have far fewer out-of-date issues than my last couple selections.  Sorry 'bout that.  I have mixed feelings about spending an entire month knee deep in the so-called "obesity epidemic," but I have high hopes for Guthman's approach.  I feel sure that, love it or hate it, it will be an interesting journey.

You coming along?  (Yeah I went there.  Forgive me.)  Really though, reading challenging material is so much more fun when there's someone around to argue with about it.  I'll bet your local library can have a copy to you asap!

A housekeeping note: I think I'm going to start putting fun titles on my blog posts again.  I miss them.  Don't you?



3.30.2015

Food Issues Book Club: Appetite for Profit, Concluding Thoughts

Hello all!  Welcome to the NOiG Food Issues Book Club, wherein I read books about food stuff, summarize each book by chapter, and then attempt to apply that book chapter's ideas to the New Orleans food environment and my own experiences.  Fun right?!  Check out previous installations here.  I'd love it if you'd read along and join in!  And now, without further ado...


Appetite for Profit, Concluding Thoughts

In the concluding chapter of Appetite for Profit, Simon offers some broad proposals on how to combat food industry sway:
  • be skeptical of how industry efforts are portrayed in the media
  • don't be fooled by promises from the industry to "self-regulate"
  • keep an eye out for nutriwashing, the industry's favorite way to pretend that it's making more healthful food when nothing has really changed
  • beware of partnerships with seemingly health-oriented organizations - often they've either been bought or were actually created by the industry
  • don't let the industry shift responsibility away from itself and toward you with arguments like "personal responsibility"
  • don't support fat-shaming and industry's insistence that problems with overweight are due to lack of exercise rather than food intake
  • remember that special considerations must be made for children
All legitimate.  And yet, if I had it to do over again, I don't think I would have chosen this book.  While approximately a million times more dense, an updated edition of Marion Nestle's Food Politics would have provided much of the same information, more effectively and with more background, concision, and context.  This book at times reads like the work of a novice with an axe to grind.  Perhaps as an attorney, Simon is too ready to argue.  (Perhaps as a paralegal, I'm too ready to fault attorneys.)

It is of course possible that it strikes me this way because the book doesn't cover any new ground for me.  Having read Food Politics over ten years ago, as well as many other articles on these topics in the years since, I have literally heard all of this before.  For a reader just being introduced to the topics, though, perhaps it's just right.

Did you read Appetite for Profit?  How useful did you find it?  Would you recommend it to others, and if so at what knowledge level?  Do tell.  And join me tomorrow as I introduce April's reading selection: Weighing In by Julie Guthman!

3.25.2015

Food Issues Book Club: Appetite for Profit, Chapter 12

Hello all!  Welcome to the NOiG Food Issues Book Club, wherein I read books about food stuff, summarize each book by chapter, and then attempt to apply that book chapter's ideas to the New Orleans food environment and my own experiences.  Fun right?!  Check out previous installations here.  I'd love it if you'd read along and join in!  And now, without further ado...

Appetite for Profit, Chapter 12: Scapegoating Lawyers

Summary:

A CCF print ad that manages to be
fearmongering, fat-shaming,
AND lawyer-shaming.
In the grand old tradition of bad actors always and everywhere, the food industry would rather create rules to protect itself than to change its harmful (profitable) ways.  This tendency was shown clearly in the mid-2000s, when a series of federal and state bills was proposed with the purpose of shielding food companies from any liability for its customers becoming obese or otherwise unhealthy.  As of 2006, 21 states (including Louisiana) had enacted laws that banned obesity-related lawsuits.  "[W]hile food companies are busy proclaiming how much they want to be a part of the solution, behind the scenes, they are lobbying to protect themselves... ."

These anti-obesity-lawsuit laws are both unnecessary and telling, based as they are on an imaginary foe.  Frivolous lawsuits - those without any real legal grounds - are already disallowed and can lead to sanctions against lawyers who bring them.  Despite what groups such as the Center for Consumer Freedom may claim, there is not in fact an "army of greedy trial lawyers" from whom the industry needs protection.  As such, the laws have been called "a solution in search of a problem."

"If food companies are so worried about becoming targets of lawsuits, why don't they change their business practices to act more responsibly?"  That is the million-dollar question.

Discussion:

I've worked with attorneys for nearly a decade now, and one thing is universally true whether they're at a firm making money$$$$$ or at a non-profit doing good: they do not - I repeat, DO NOT - file cases that they can't win.  They certainly don't file cases that are actually frivolous per the law - that's the kind of thing you lose your license over.

Of course one (now-notorious) case was filed in 2002 against McDonald's.  A class action on behalf of several ill children, the case was less about obesity than about deceptive advertising, obfuscation, and accountability.  The case was dismissed in 2003 not because it was frivolous but because "the plaintiffs had failed to show that McDonald's engaged in deceptive practices and that consumers had inadequate access to information about McDonald's products."  The case was appealed and remanded (sent back to the court in which it was originally heard), and ultimately was "voluntarily dismissed with prejudice" in 2011 which frankly I don't understand.  But it was never ruled to be frivolous.

Another case was filed in 2012, specifically about the inclusion of toys in HappyMeals; it too was dismissed - but not because it was found to be frivolous.  The lawyers at McD's who throw around that word know what they're doing - they know that it has a different meaning in the legal world than in general discourse.  I'd love to see them sanctioned for it.

As for Louisiana's so-called "Commonsense Consumption Act" (Act 158 from the 2003 legislative session, in state law as LA Rev Stat § 9:2799.6), wouldn't it be great to get that repealed?  Just to send the message to food companies that they are liable for the products they sell, just like tobacco companies and asbestos companies before them?  Perhaps someone can work on it for the next legislative session.  For policy dorks, please take note that ALEC provides a model CCA on its website - that should tell you something about its true intent.

3.23.2015

Food Issues Book Club: Appetite for Profit, Chapter 11

Hello all!  Welcome to the NOiG Food Issues Book Club, wherein I read books about food stuff, summarize each book by chapter, and then attempt to apply that book chapter's ideas to the New Orleans food environment and my own experiences.  Fun right?!  Check out previous installations here.  I'd love it if you'd read along and join in!  And now, without further ado...

Appetite for Profit, Chapter 11:
Regulating Junk Food Marketing to Children

Summary:

The marketing of foods to children is an emotional, hot-button topic - particularly when it comes to junk food.  In 2005, the Institute of Medicine showed that the marketing of low nutrition foods promotes a preference for such foods among kids.  While correlation is not causation, it found that "the statistical association between ad viewing and obesity is strong."  In short, this advertising is bad for children's health.

Government regulation efforts have been ineffective in limiting kids' exposure to junk food advertising.  Industry's favorite tactic is to cry "First Amendment" at any such proposal.  This is despite the fact that "commercial speech" - the category into which corporate advertising falls - can be limited in light of "a pressing social interest" per the Supreme Court.  But food companies don't let reality get in the way of "a convenient excuse that covers up a self-serving desire to maintain the status quo."

Industry's next tactic is to market its healthier foods to kids - the troubles being that a) they are still marketing directly to children, who have a limited capacity to make good choices and most often rely on parents to buy desired products; and b) the foods aren't actually healthy, only nutriwashed.  "How can we begin to discuss eating the right food unless and until we talk about controlling an industry that spends billions of dollars a year trying to get children to eat the wrong food?"

It's been suggested that the government should increase spending on promotion of healthful foods and eating habits, but the reality is that no government agency can match the advertising budgets of the food industry.  Bans on advertising aimed at children have proven effective in other countries.  We must implement policies that prevent the exploitation of our children.

Discussion:

I feel like this chapter should have been placed before the chapter on food in schools.  Ah well.  Anyway, is there still junk food being marketed to kids?  What ever are they talking about?  It's not as if it's ABSOLUTELY EVERYWHERE.  It's not as if experts have explained time and time again that such marketing is detrimental.

At least TV ads aren't quite this obviously aimed at kids anymore, like they were when I was a kid...



...right?




For more info about food advertising to kids, check out this report released by PCRM - featuring New Orleans pediatrician Leslie Brown!