Tag Archives: Health

Addressing the sleep deficit, NOT one person at a time

The more I learn about health and wellness, the more convinced I am that sleep is magic.

Not only does getting the recommended 7-9 hours help you feel awake and refreshed in the morning, it also helps regulate your metabolism and improves your memory, focus, judgment, problem solving, and athletic performance.

New and terrifying research links not-enough-sleep (the 5-6 hours most Americans currently get) with weight gain, increased risk of cold/flu, diabetes, cancer, and ADHD-like symptoms. Additionally, not getting enough sleep results in poorer cognitive abilities (lack of focus, concentration, ability to remember what you’ve learned), poor judgment, and impaired driving on par with drunk driving. It’s also correlated with depression, anxiety, and other mental illness.

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When I saw this New York Times post basically summing it all up (and providing links if you want to check out the research) I was ecstatic and all “That’s what I’ve been saying!” Then I read the comments.

“You assume it’s a choice, that people actively choose to get less sleep and, if they want to, can choose to get more. That may well be true of upper class people who can hire others to do their work for them – housework, tutoring, etc. As for me, a middle class shlub, well, I would LOVE to get more sleep. But I am a single mom. I have to get up at 5:30 am for my job. And I have to work or I will land in the street with my kids. ANd I have to stay up at least until 10:30 pm most nights to get this or that child hither and thither, help with homework, and son on. I cannot hire anyone to do any chore– lawnmowing, housecare, homework, driving, shopping, bill paying, college planning for kids, etc etc etc etc. Basically, I work from the moment I get up until the moment I sleep. I have no time to exercise either.”

And it hit me. The sleep deficit is a lot like the obesity epidemic; it is a systemic problem that cannot be solved by encouraging individuals to make healthier choices.

I work with college students who probably could get more sleep if they spent a couple fewer hours playing videogames.

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Shit college students say.

Of course, some of my students work more than the recommended 10 hours per week and can’t choose to sleep more. But in general, I feel okay about trying to encourage them to prioritize sleep over partying or more time on Reddit because they can usually make changes without too much trouble. For the general adult population, however, this really isn’t the case.

The comments on the New York Times post read like a laundry list of reasons why Americans are not sleeping. Parents are kept up by new babies. Physicians-in-training are working 28-hour shifts. People who travel constantly for work (flight crews, journalists, musicians, etc.) are forced to keep irregular schedules in different time zones. Single parents are working full time jobs in addition to the “second shift” just to make ends meet.

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But it isn’t just our jobs, families, and full schedules that are keeping us up. The world has changed. Energy drinks and caffeinated latte drinks are sold on every corner and and marketed either as health supplements or entertainment. We are constantly connected, if not tethered to, our phones, tablets, and the internet — whether it’s for work, entertainment, or connection. A recent study found that the light from backlit screens can disrupt sleep by suppressing melatonin, a hormone that helps regulate our circadian systems. But this is even bigger than a gadget issue.

Our circadian rhythm, which is how our body knows when to sleep and when to wake, is informed by both light and temperature. Darkness and cooler temperatures let our bodies know it’s nighttime, and therefore bedtime. So what happens to our circadian rhythm when we live in consistently temperature-controlled environments? And about that darkness thing? Yeah. We don’t really have that anymore. Just check out these NASA images of the world at night.

Captured in 1994

Captured in 1994

Light pollution projected growth

Light pollution projected growth in 2025

So basically our artificial environment is  really screwing with our circadian systems, and we wonder why no one can sleep? Some scientists are even concerned that light pollution is killing off wildlife.

Animals need sleep too.

Animals need sleep too.

It’s no wonder that the New York Times post, which encouraged readers to get more sleep and discuss the issue with their doctors, made some people angry. For so many of us, sleep is simply outside our realm of control. Before I’ve made the argument that our obesity problem should not be addressed through individual behavior change because it is a systemic problem that can really only be solved through systemic changes to our environments and our policies. When we try to treat obesity as if it were simply an individual problem, it manifests as shaming people for things beyond their control. When we consider that sleep and weight are inextricably linked, it’s not surprising that the same thing happens when we tell people they need more sleep.

And, just like weight shaming can cause people to develop eating disorders or depression/self-esteem issues that lead to further weight gain, warning people about the health risks of sleep deficit can actually make the problem worse:

“As a law school graduate studying for the New York Bar and planning an impending move to NYC–without yet a job, praying to find one in public interest law–I lie awake every night, worrying.  But at least now I know all of the harmful things that are happening to me.”

“Constantly counting the number of hours of sleep I got each night hasn’t been good for my mental health either. It’s like counting calories. It made me obsessed. So I stopped.”

“One thing that would help me sleep is not being constantly told how awful it is not to get it.”

The Health Belief Model of behavior change tells us that if you scare people about a health issue without providing a clear solution for how they can prevent or treat it, they are not going to respond well. Telling folks the dangers of not getting enough sleep without providing realistic solutions will cause them to feel like it’s hopeless and shut down. This issue cannot be solved by telling people to try to get more sleep.

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So how can we address the sleep deficit at the systematic level? In college health we have an advantage because we have a fair amount of control over the environment our students inhabit. We have the ability to provide a campus that encourages and supports healthy behavior. We can close down our libraries, gyms, labs, and campus centers at 10 pm. We can ban 8 am classes to let our students sleep in later. We can mandate quiet hours in our residence halls. We can ban Red Bull and 5 Hour Energy from promoting their goods on campus. It’s a little more complicated in the real world.

tumblr_inline_mmq91iJGyJ1qz4rgpWhat could some of those systemic changes look like? Is it even possible to regulate light pollution in urban areas? How would we accomplish that? We could tax the crap out of energy drinks like we tax cigarettes. We could create similar disincentives for 24-hour service availability. For example, in Spain, most businesses are closed during siesta in the afternoon. People simply have to run errands another time, and they make it work. We could also place stricter regulations around the “full time” (read: eligible for benefits) work week, reducing it from the standard 4o-45 hours to something closer to 35. (Again, a lot of Europeans do it this way.)

But beyond regulation, true systemic change requires a culture shift. We need to foster a culture that doesn’t reward employees for putting in extra hours, or make anyone feel like they need to put in extra hours to keep their job. In industries where it’s possible, like in most office jobs, we need to institutionalize flex time and let workers telecommute in order to snooze that extra hour it would take to commute. We need to change the norm from one where we lie in bed with our phones checking email to one where that kind of behavior is uncommon. We could stop creating reasons for people to stay up late, like scheduling evening events earlier and no longer airing popular TV shows after 10 pm.

But this kind of societal change takes decades and requires tireless efforts from public health folks and other advocates. Perhaps the first step of that work is recognizing that the sleep deficit is bigger than you and your insomnia, her and her new baby, or him and his ridiculous work schedule. For those who can make the choice to sleep more, doing so will definitely improve their health. But the focus of public health messaging and health journalism should not be to scare or shame people who, for whatever reason, can’t get enough sleep.

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TL;DR sleep zombie friends?

What I’m really trying to say is that the only way to really address the issue is to treat society’s sleep deficit as the gigantic, systemic, clusterfuck of a problem that it truly is.

Goodnight.

Goodnight.

Healthy Choice™ and healthy changes

I’ve recently taken note of a new ad campaign by Healthy Choice stating, “Don’t diet. Live healthy.” Turns out the campaign isn’t actually that new since the New York Times covered it in September, 2012, but since I didn’t have television until recently, it’s new for me.

I liked this ad as a wellness educator and body image researcher, and as a former dieter and purchaser of SmartOnes Weight-Watchers-friendly frozen dinners, it made me laugh.

Yes, you heard right. I am a former dieter. At the end of 2012, after yet another frustrating year of failed attempts at dieting and weight loss, I made a serious decision. I decided to stop dieting, forever. I cancelled my Weight Watchers Online subscription for what will be the last and final time. It all started last year when I started researching body image and “fat talk” for my dissertation-equivalent Health Communication project. Conducting that research often and unintentionally became “mesearch,” forcing me to examine my own feelings and behaviors with the intensity of a laser beam. It was painful and I did not like what I found.

I learned that I was one of the 90% of students with body image concerns. I learned that body image disturbance, an umbrella term for body image dissatisfaction and distortion (believing you are bigger than you really are), is associated with depression and low self-esteem. I learned that I was one of the majority of women who engaged in “fat talk” — a term coined in 1994 to describe the specific way girls and women talk to each other about the size and shape of their bodies or diet and exercise regimens, typically in a negative or self-disparaging manner. “I’m so fat.” “You’re not fat! If you’re fat, what does that make me?”

After leaning that fat talk is associated with greater body image disturbance and thin-ideal internalization (the idea that skinny=pretty) and coming to understand the way it normalizes and reinforces body image concerns at the societal level, I started paying attention. It was staggering to realize how many of my conversations with other women were about dieting, exercise routines, the clothes we “could” or “couldn’t” wear, how much weight we wanted to lose, the reasons why we hadn’t been able to “commit” to our weight loss plans. I never realized how often I apologized for eating (“I’m sorry but I’m getting a big burrito tonight”) or made excuses for eating (“I ate like nothing all day today so I’m going to get fries”).

I started to learn more about dieting. I began to realize that all dieting is bad. Yes, ALL dieting is bad. Even if you really need to lose weight for medical reasons like heart disease or diabetes, dieting only helps in the short term. Dieting offers nothing that might help you stick to your diet. Dieting doesn’t help once you’ve reached your goal weight. Cleanses and fasts are even more stupid than diets. They’re like douching–completely unnecessary when you’re healthy, and potentially harmful when you’re not.

I have come to believe that dieting is unhealthy. Slowly but surely, I came round to the philosophy behind Health At Every Size. Believe me, it took a while.

I am overweight but not horribly so. I have been this way for most of my life. I have wanted to lose weight ever since I was 10 years old. That’s a long time to want something. So, making the decision to stop dieting and pursue health rather than weight loss is nothing short of worldview-shattering. A complete about face. A completely new paradigm positioned 180 degrees from my former belief system.

This kind of conversion doesn’t happen easily or quickly. I’ve sat and mulled and struggled with these feelings and developing beliefs for a year or two now. Even today I’m still often shocked by how radical they sound to my own ears. Deciding to stop dieting has been one of the most terrifying things I’ve ever done, and I’ve just barely gotten started.

I created a plan for myself. Instead of dieting, I would:

  1. Get active for the right reasons. Find and embrace the pleasure in physical activity. Exercise because it feels good or to meet goals other than weight loss (do 30 push ups, hike that mountain, etc.).
  2. Learn to cook and eat take-out and prepared food less often
  3. Practice mindful eating, listen to my hunger signals, etc
  4. Practice good sleep hygiene (lack of sleep affects the hormones that regulate your appetite and feelings of satisfaction after eating, not to mention the myriad other physical and mental effects)
  5. Cut out “fat talk” entirely; if others around me are doing it I will not participate or change the subject

Truthfully, I started on number five about a year before I made the rest of my plan to stop dieting. Cutting out fat talk turned out be easier than I thought. At first it felt awkward and I didn’t know how how to act or react when friends and coworkers launched into the usual self-put downs and mutual reassurance tango. It turns out that simply not participating or changing the subject works pretty darn well. In a couple of instances, I talked with some close friends about it and my decision to stop. They were receptive and overtime less and less fat talk creeped into our conversations. Overall, I think I am happier for it. Now when I hear fat talk I’m struck by how annoying and insipid it is, and grateful that it’s no longer a part of my social repertoire  It’s been harder, of course, to silence the fat talk that goes on inside my own head, but hey. One step at a time.

This January, I  started the rest of the plan. The first week of diet-free living felt amazing. It was FREEDOM. I felt great to eat something “normal” (non-diet food) and even better to allow myself to NOT feel guilty afterwards. The elation didn’t last long, though, as my insecurities and doubts bounced back with a vengeance. They’re still with me today, louder than ever:

I doubt that I will be able to make any real measurable changes in my weight or my health without dieting. I doubt I will be able to stick to my 5 point plan. I doubt I will be able to be happy if I stay at my current weight, even if I’m super healthy and fit.

I doubt everything regularly, but I’m so committed to building sustainable, healthy habits that will last for the rest of my life that I can’t give up.

It turns out that quitting dieting is the easiest part of making this lifestyle change. A harder part is actually developing and maintaining my new, healthier, lifestyle and the hardest part of all is silencing the doubts and insecurities that make me want to give up or give in to the seeming futility of it all.

I appreciate the message behind Healthy Choice’s latest ad campaign: “Don’t diet. Live Healthy.” I believe it to be a healing message for both individuals and our sick culture. Of course, if it were easy to “live healthy” in America today we wouldn’t have turned to dieting in the first place. And as great as Healthy Choice products are (that is, marginally better than SmartOnes and other diet food), frozen dinners are not the answer.

“All Adventurous Women Do”

HBO's GirlsOn the third episode of HBO’s new series, Girls, the protagonist Hannah (played by creator Lena Dunham) is diagnosed with human papilloma virus (HPV). Distraught, she tells her best friend, who replies with the most revolutionary phrase ever uttered on television regarding STI stigma: ”All adventurous women do.”

STI stigma is not difficult to understand. Since STIs are sexually transmitted, they’re easy to interpret as punishment for promiscuity. People with STIs are often characterized as slutty, dirty, trashy, or stupid and reckless. And when someone is diagnosed with HPV–no matter how confident she is in her choices, no matter how careful she is–she’s faced with the crushing weight of this stigma. She must try her darndest not to internalize it–not to believe that she is being punished for her sexuality, not to believe that she brought this upon herself, or that this viral infection is indicative of poor moral character. This is extremely difficult because no one has prepared her for this, and she will almost certainly go through it alone.

Since HPV and STIs are treated as a shameful secret, we don’t ever talk about what the process of diagnosis and its aftermath is like, and as a result, we never hear what it was like for someone else. We each have to figure out how to cope on our own, in silence, without the comfort or guidance of those who have been there and can understand. There are no celebrity spokespeople for HPV. No star athlete role models. And so very few narratives in television, film, or literature.

It’s rare to see STIs on television. Rather, it’s rare to see STIs on television outside of medical and crime dramas where STIs are used as a “who done it” plot device to reveal some unexpected twist regarding infidelity or some otherwise inappropriate sexual behavior. It’s rare to see a character simply living with an STI–getting diagnosed, experiencing treatment, navigating relationships, and dealing with shame and stigma in every day life. It’s rare, but it shouldn’t be.

HPV is the most common STI in the United States. The CDC approximates that 20 million Americans currently have HPV, with six million new infections occurring each year. (For reference, 20 million people is roughly the population of Beijing, New York state, and the entire country of Australia.) The CDC estimates that 50% of sexually active Americans (men and women) will contract HPV at some point in their lives, although the American Social Health Association thinks it’s closer to 75-80%. For women, the rates are even higher: the CDC estimates that, by the age of 50, at least 80% of women will have acquired sexually transmitted HPV.

So, if at least 50% of Americans will one day have the experience of being diagnosed with HPV, shouldn’t we be doing something to prepare them for that moment so that the bottom doesn’t drop out from under them? Shouldn’t we let them know that this is a shared experience and that they don’t have to feel so alone? Shouldn’t we be working to combat stigma at the social level so that we can reduce the emotional damage it inflicts?

Writing HPV and other STIs into television narratives is a great way to challenge and combat stigma. Especially when the character is able to make peace with the diagnosis, providing a model for the rest of us.

“All adventurous women do.”

In that one glorious sentence, Girls let us know that HPV is common and that instead of a being a sign of poor character, it’s a mark of an adventurous spirit. This one line erases the stigma and reframes HPV as something normal, even positive. “All adventurous women do” allows Lena Dunham’s character Hannah to own the diagnosis, to embrace it, to wear it as a badge of honor. And it teaches the rest of us–all of us girls who have felt the waves of shame and guilt crashing on top of us, suffocating us–that we are okay. That HPV, much like traveler’s diarrhea, is just another part of the experience of being an adventurous woman in the 21st Century.

Positive body image won’t make you fat: The case for body positive health promotion

I’m currently designing a social marketing campaign to improve body image among undergraduate women at a major university. On three different occasions, my classmates—a cohort of public health, nutrition, and health communication students in leading graduate programs—expressed concerns about my project, asking “Aren’t you worried that you’re promoting obesity?”

There seems to be a dangerous misconception in the public health community that the goals of positive body image promotion and obesity prevention are at odds. That somehow, by helping people feel better about their bodies, we will inadvertently “encourage” obesity.

But body image promotion isn’t about glorifying fatness, just like obesity prevention isn’t (or shouldn’t be) about the glorification of thinness. More accurately, body image and weight management are interconnected elements of holistic mind-body approach to health and ultimately, the public health community has more to gain by thinking of them as complementary rather than competing interests.

Obesity prevention efforts may appear to benefit from a status quo that stigmatizes fatness and worships thinness, but the evidence just doesn’t support it. We live in a culture that idolizes underweight supermodels and relegates fat actors to fart and food jokes, and yet none of it has done anything to make people healthier.

A lot of people worry—myself included—that without body dissatisfaction, we would lose our motivation to slim down. It’s an easy trap to fall into because, for many of us, negative thoughts are the only motivation to lose weight we’ve ever known. It’s scary to imagine life without our internal “fat talk”; it takes work to imagine using positive feelings as a source of motivation.

But contrary to popular belief, shame is not a good motivator. In addition to reinforcing an impossible, demoralizing standard of beauty, using fat shame as motivation will always backfire. Fear, shame, and self-disgust may prompt people to change their habits temporarily, but once they start to feel better and the bad feelings dissipate, they are bound return to old habits. Motivation-by-fat-shame doesn’t create a culture of health; it creates a culture of yo-yo dieting and January gym memberships abandoned by March.

Not only does fat shaming fail to help people get healthy, it actively hurts people, leaving maelstrom of negative body image, low self-esteem, depression, eating disorders, and other pathological eating and exercise behaviors in its wake. This is no small matter, as these conditions cause pain and suffering for millions of men and women, of all ages, all over the country and the world.

Obesity prevention efforts that reinforce the thin-ideal status quo are doomed to perpetuate a broken system where body image dissatisfaction is normative, obesity rates keep rising, and the multi-billion dollar weight loss industry capitalizes on both. But obesity prevention efforts that embrace positive body image promotion, on the other hand, have a chance to break the cycle.

Meaningful body image promotion encourages women to reject the tyrannical and reductive thin-ideal portrayed in the media, and to understand that pursuing a healthy lifestyle for its own sake is much more rewarding than obsessing about dieting and weight loss. After all, “thin” doesn’t translate to “healthy.”

For example, the Health At Every Size (HAES) movement is based on the understanding that weight does not determine health, and that exercise and good nutrition are beneficial, whether or not they result in weight loss. Instead of using BMI, HAES advocates using more specific measures, like blood pressure and cholesterol, to determine one’s health status.

Instead of relying on body dissatisfaction, HAES teaches us to draw motivation from positive sources, like the desire to explore new hobbies (yoga, archery, kickball), to achieve new goals (run a 5k, learn to surf), or to enjoy the flavor and feeling you get from nourishing your body with healthy foods. This is the kind of lifestyle change that keeps people engaged and motivated for the long haul, and it will keep us healthier, whether or not we’re overweight. Also, it’s fair to say that by letting go of the “impossible dream” of one day looking like the (photoshopped) people on the cover of magazines and by learning to accept and love our bodies as they are, we’ll be happier too.

This type of holistic approach—incorporating positive body image, mental health, physical activity, and good nutrition—is actually sustainable because it promotes an understanding of “health” as a lifelong process rather than a set of restrictions or punishments to be lifted once you reach that magic number on the scale.

We know that there are no health benefits to negative body image. So why would we limit the scope of obesity prevention to exclude the potential benefits of positive body image?

Encouraging positive body image does not “promote” obesity. Rather, it helps people let go of the shame, fear, and unsustainable weight loss behaviors that are keeping them trapped in a state of bad health.

My abortion story

I’ve been choosing abortion for 10 years, and that choice has shaped the course of my life.

Today I blogged about my abortion story on Role/Reboot:

If I got pregnant today, I would have an abortion

As a 16-year-old, I knew that if I got pregnant by accident I would have an abortion. Ten years later, I am in a completely different place—a place where I could, realistically, support and parent a child—and I would still choose abortion.

I believe in the power of telling stories. With the 80 new restrictions on abortion rights enacted by state legislatures in 2011 and more coming every day, I believe it’s especially important to tell stories about abortion and the role it plays in creating an egalitarian society that allows women, and men, to control their destinies. Until recently I felt like I didn’t have a story to tell because I haven’t had an abortion. I cannot speak to the experience of making that decision or undergoing the procedure. But I realized that I do have a story, a story that has grown with me as I matured from a 16- to 26-year-old adult who could, if I chose to, be a mom.

Continue reading at Role/Reboot.

The MBTA should not allow advertising from crisis pregnancy centers

The MBTA is where you’ll usually find ads for Jamba juice and Jansport backpacks, local research studies, and public health campaigns. Currently, though, much of this highly-coveted space is occupied by ads for Daybreakinc.org, an anti-abortion crisis pregnancy center. The ads don’t tell you that Daybreak has an anti-abortion agenda; they claim to offer “compassion,” “empowerment,” “hope,” and most inaccurately, “options.” This is in fact the major criticism of crisis pregnancy centers—that they misrepresent themselves as neutral parties. They are not, and they should not be allowed to advertise their heavily-biased and manipulative services on the MBTA.

The point of a crisis pregnancy center (CPC) is to keep pregnant women from having abortions, often by delaying them with offers of pregnancy tests and ultrasounds until it’s too late. What is truly sinister about CPCs is their use of untrue or misleading information to scare women away from choosing abortion, with false claims such as: abortion causes breast cancer, abortion is psychologically damaging, abortion can lead to sterility, and birth-control pills cause abortion. A 2006 Congressional investigation found that 87 percent of the centers surveyed provided false or misleading medical information.

Daybreak is guilty of this type of misinformation, although they are careful not to appear so on their website. It’s no wonder they are covering their behinds—legal action has been taken against CPCs in a number of states regarding their deceptive advertising in New York, California, Ohio, Missouri, and North Dakota.

According to their website, Daybreak claims to provide “accurate information about pregnancy, fetal development, lifestyle issues, and related concerns” as well as offer “accurate information about abortion procedures and risks.” They say “our advertising and communications are truthful and honest and accurately describe the services we offer.” But when you dig in deeper, you will find a sample if misleading and just plain untrue “facts” on their website:

  • Daybreak claims: “[Plan B] It may alter the uterine lining which prevents the fertilized egg from implanting, resulting in an early abortion.” (This is wrong—the dissolution of a fertilized egg is NOT “early abortion.”)
  • Daybreak claims: “Complications may happen in as many as 1 out of every 100 early abortions,” when according to the Guttmacher Institute, “the risk of abortion complications is minimal: Fewer than 0.3% of abortion patients experience a complication that requires hospitalization.”
  • Daybreak claims: “Women who have experienced abortion may develop the following symptoms: guilt, grief, anger, anxiety, depression, suicidal thoughts, difficulty bonding with partner or children, eating disorder,” when the American Psychological Association’s Task Force on Mental Health and Abortion reported that “the best scientific evidence published indicates that among adult women who have an unplanned pregnancy the relative risk of mental health problems is no greater if they have a single elective first-trimester abortion than if they deliver that pregnancy.”
  • On the particularly appalling “For Men” section of the Daybreak website, they write: “Many women who have had abortions report that they were waiting for their boyfriends/husbands to stop them. Some even say that they sat on the table hoping the father of their baby would ‘rush through the door to rescue me and take me away somewhere safe.’” (Um, citation needed?)

I’m not trying to make the argument that free pregnancy counseling is a bad thing or that the people at Daybreak are “bad” people, but pregnancy counseling, or any counseling for that matter, should be unbiased and informative. No where on the Daybreak MBTA ads are women informed that the the “free pregnancy counseling” is actually anti-abortion counseling, and that is dishonest, manipulative, and ultimately wrong. Women facing unplanned pregnancies need to know all their options, without the implication that one is better than another, and they need real medical information, not the “facts” listed above.

The MBTA is currently under fire for proposed fare increases and service cuts. They may be desperate for funds, but that does not excuse this moral misstep. CPCs are a growing threat to women’s health and the MBTA is the last place Bostonians should be exposed to anti-abortion propaganda.

“Shame and Blame: Facing the Unintended Consequences of Health Messaging” on Huffpost

Today my op-ed on shame and blame in health campaigns was published on the Huffington Post. Check it out!

Shame and Blame: Facing the Unintended Consequences of Health Messaging

A solemn black and white poster shows a picture of an obese girl with copy that reads: “Warning: It’s hard to be a little girl if you’re not.” Another poster displays a woman’s naked legs with her panties around her ankles and the word: “She didn’t want to do it, but she couldn’t say no.” The first is part of the Georgia “Strong 4 Life” campaign to prevent childhood obesity; the other is part of the Pennsylvania “Control Tonight” campaign to reduce excessive alcohol consumption. Though the campaigns are unrelated, they have one thing in common: disregard for the effects of shame and blame — the frequent unintended consequences of health campaigns.

The promotion of health and social welfare is one of those noble causes that attracts people who want to “do good.” Physicians are taught to “First, do no harm,” but health communication professionals take for granted that their work is “doing good” without considering that it might cause unintentional harm. For example, stigmatizing sexually transmitted infection (STI) prevention messages may make people with STIs too embarrassed to seek treatment or too ashamed to tell their sexual partners. Not only can health promotion messages lead to such negative health outcomes, they can also promote destructive social values, like fat stigma and rape culture.

Read the rest at the Huffington Post.

Quick hit: Shaming fat kids doesn’t solve anything

Strong 4 Life campaign

According to the Georgia Strong 4 Life childhood obesity campaign website, “Ignoring this problem is what got us here.”

It’s true that childhood obesity is a big problem, but you know what DIDN’T cause the childhood obesity epidemic?

Ignoring the problem.

You know what did?

  • Income disparity
  • Food deserts
  • Fast food advertising
  • The whole fast food industry
  • Corn subsidies
  • Policies like the one declaring that pizza counts as a vegetable in school lunches
  • Lack of safe outdoor play space for inner city kids
  • Video games
  • Lack of funding for physical education
  • Poverty

You know what this ad does?

  • Help families alleviate/prevent childhood obesity
  • Blame this kid for being a fatty fat.

Know what blaming kids for being fat does?

  • Makes them lose weight
  • Encourages a culture of fat stigma and fat shaming that fuels bullying
  • Increases negative psychological, emotional, and health outcomes among overweight and obese children, such as low self-esteem, body image disturbance, eating disorders, and even suicide.

Way to go, Children’s Healthcare of Atlanta.

Well intentioned Facebook meme misses the point

A ‎15 year old girl holds hands with her 1 year old son. People call her a slut. No-one knows she was raped at 13. People call a girl fat. No-one knows she has a serious disease which causes her to be over weight. People call an old man ugly. No-one knows he had a serious injury to his face while fighting for our country in the war. Re post this if you are against bullying and stereotyping. 95% of you won’t

I keep seeing this Facebook status meme pop up from time to time, and every time, it makes me angry. Sure, I’m against bullying and stereotyping (is anyone really pro bullying and stereotyping?) but I don’t at all agree with the message here.

Sure, it’s important not to assume that all teen mothers became mothers by choice. It’s important not to assume that every teen mother became pregnant through consensual sex or irresponsible behavior. Yes, it’s important to understand and recognize that some pregnancies are the result of rapes, and that some young women are forced to carry their babies to term because of shitty barriers to contraception, Plan B, and abortion access. Maybe she was forced to carry the baby to term because of parental notification laws, or the crowds of anti-Choice protesters outside her local Planned Parenthood, or even simply because abortion is too stigmatizing or incompatible with her family’s beliefs or culture to consider.

But even if a teenage girl did become pregnant through consensual sex – even if she was irresponsible – even if she had consensual, unprotected sex with multiple partners – she still doesn’t deserve to be called a slut. Nobody deserves to be called a slut, ever, for any reason. Because there’s nothing wrong with having sex. Even when you’re young. Even when you’re not married. Even if it’s with multiple partners.

Sure, it’s important to realize that there are a myriad of different reasons why a person might become overweight. It could be the result of an illness, or a medication, or a genetic condition and no fault of her own. But it could also be a result of an eating disorder, or stress eating, or poverty, or a lack of education about nutrition. It could be because she’s too busy working 14 hours a day to shop at a grocery store and prepare healthy meals. It could also be because she loves food and doesn’t really care if she conforms to the unrealistic American beauty ideal of the size 2 supermodel. She might be happy with her body exactly how it is.

But no one deserves to be discriminated against or bullied for being fat, ever, for any reason. Even if their weight appears unhealthy, even if they just fucking love to eat hamburgers. Because fat people deserve respect, even if they’re fat because they’re lazy, even if they’re unhealthy. Because people come in all different shapes and sizes, for all sorts of reasons. Because there’s no wrong way to have a body. And because someone else’s weight is really none of your business.

Yes, it’s important to realize that sometimes people look different and sometimes they were injured while serving our country. But sometimes people look different because they were injured for some other reason. Maybe it was a car accident. Maybe it was a drunken hang-gliding accident. Maybe there was an accident at work because of lax safety standards. Maybe it wasn’t an injury, but an illness, or a condition that developed over time, or maybe they were just born that way. Maybe there’s nothing wrong with a person’s face other than the fact that it doesn’t look like the faces we see in magazines. Maybe it’s not a person’s face, but their body. Maybe they use a wheelchair or a cane. Maybe they sound different when they speak. Maybe they cannot speak, or cannot hear, or cannot see. No one deserves to be called ugly, no matter what they look like or sound like or how they came to be that way.

Though I can recognize that the meme is well-intentioned, it suggests that while some people don’t deserve to be bullied or stereotyped, other people do. Because they “brought it on themselves” by acting irresponsibly or just because they don’t have a “good excuse” for being the way they are. But nobody deserves to be stereotyped or bullied, for any reason.

When someone falls outside the norm, they become a target for bullying and stereotyping just because they’re different. And everyone is different at least some of the time. There’s no point to trying to determine who “deserves it” and who doesn’t. Because bullying and stereotyping is cruelty, and no one ever deserves that.

So if 95% of people aren’t reposting this status meme, let’s hope it’s because they agree that EVERY 15 year old mother, EVERY overweight person, and EVERY person who’s body is in some way “different,” deserves our respect and compassion.

Too big for a stroller?

Today I discovered Walk, a new Tumblr site sharing photos of kids in strollers who are too old to be using strollers. The sentiment behind the site seems to be that kids who are old enough to walk should walk. The friend who posted it on Facebook wrote “Seriously, if your kid can walk without falling, your kid should walk without falling.” I can see how some might be annoyed by the sight of 7-11 year old squeezed into a stroller, but Walk is perhaps saying more than was intended.

As I looked through the photos, I couldn’t help but notice that a fair few of the kids in strollers were overweight. Considering that childhood obesity is a growing problem in the U.S., this may not be coincidence.  According to the CDC, rates of childhood obesity have more than tripled in the past 30 years. The prevalence of obesity among children aged 6 to 11 years increased from 6.5% in 1980 to 19.6% in 2008. Childhood obesity is a serious problem because it sets kids up for a lifetime of chronic illness and health issues. It also makes kids more susceptible to bullying and fat-shaming from their peers and society at large. While the causes of childhood obesity are multifaceted and complex, one is undoubtedly a lack of physical activity.

I strongly believe that when it comes to obesity, it is unfair to put all the blame on the individual. Our society promotes and condones unhealthy eating and sedentary lifestyles in a number of ways: the fast food industry, an economy based on office jobs, car-based societies, corn subsidies, food deserts, etc. For those who are low-income, a healthy lifestyle is almost impossible considering the lack of access to safe public recreation spaces, lack of leisure time, and high costs of fresh, healthy foods.

Perhaps another way that our culture unknowingly reinforces unhealthy behaviors is through “stroller culture.” Now, I’m not saying that there’s anything inherently bad about strollers (like Maggie Gyllenhaal‘s character in Away We Go), but that perhaps we use them too often and for too long. Looking at some of the images on Walk, it seems that might be the case. What are we teaching our school-aged children when we don’t expect them to walk alongside us? If anything, we’re reinforcing the idea that walking from the parking lot to the store is an imposition, or that physical activity is separate from the experience of living every day – something we only experience at the gym or playing sports.

My mother came out to Boston to visit on Mother’s Day. We were heading from my apartment in “Camberville” into the city, and I suggested that we could avoid the 18 minute walk to the T stop by taking a bus. She gave me a lecture on how walking was part of the urban experience and part of a healthy lifestyle.  At age 25, is my mom still pushing me out of the stroller?

I’m wary that Tumblr sites like this can often become places for fat-shaming (like People of Walmart) and I would hate for this to happen with Walk. Still, it is a reminder that walking is part of a healthy lifestyle for kids as well as adults.