Answering questions: Can you be healthy but not fit?

I put some time into recent responses on Quora and figured I'd share them here, too, since I clearly need to work on writing more consistently.

Can you be healthy but not fit?

Yes, but we need to define our terms first.

Americans in the US typically use “fit” to describe physical fitness and athletic capability, whereas other English-speakers in the world may use it to describe people’s appearances and level of attractiveness. The juxtaposition of “healthy and fit” implies the former definition (physical/athletic ability).

“Healthy” has myriad definitions, but I assume the questioner means metabolic health, which includes measures of blood pressure, triglycerides, LDL-cholesterol, HDL-cholesterol, total cholesterol, fasting plasma glucose, etc.

There are, indeed, many people who test in the “normal” and “healthy” ranges on such metabolic measures but who do not exercise regularly and/or may have physical limitations or disabilities that limit fitness endeavors. Metabolic measures are frequently influenced by genetics, so that “health” is not entirely within our control. But those influences can result in good metabolic health or poor metabolic health independently of physical fitness, which takes action and training to achieve.

Physical fitness can influence metabolic health, as metabolic health can influence physical fitness. If a person has naturally high blood pressure, it might not be safe for them to undertake an intense exercise regimen in pursuit of physical fitness. However, researchers have found that “even low levels of physical activity have a beneficial effect on metabolic fitness and the overall health of the individual.” (https://www.ncbi.nlm.nih.gov/pub...)

Many doctors erroneously mistake weight/BMI as a proxy for health. From the article “Weight Science: Evaluating the Evidence for a Paradigm Shift”:

• Yet using BMI as a proxy for health may be more costly than addressing health directly. Consider, for example, the findings of a study which examined the "healthy obese" and the "unhealthy normal weight" populations . The study identified six different risk factors for cardiometabolic health and included subjects in the "unhealthy" group if they had two or more risk factors, making it a more stringent threshold of health than that used in categorizing metabolic syndrome or diabetes. The study found a substantial proportion of the overweight and obese population, at every age, who were healthy and a substantial proportion of the "normal weight" group who were unhealthy.
• Psychologist Deb Burgard examined the costs of overlooking the normal weight people who need treatment and over-treating the obese people who do not. She found that BMI profiling overlooks 16.3 million "normal weight" individuals who are not healthy and identifies 55.4 million overweight and obese people who are not ill as being in need of treatment. When the total population is considered, this means that 31 percent of the population is mis-identified when BMI is used as a proxy for health.

So athleticism, metabolic health, and body size are all different variables, and while any one of them can influence another, none definitely determines or defines another. A person can be healthy and not fit. A person can be fit and have poor metabolic health. And a person can be either of these at any size or weight.

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Define "Transformation"

Transformation photos are highly problematic because success and human worth are not size-dependent, nor should happiness be. Intentional weight loss is not shown to improve health. Intentional weight loss efforts are most likely to result in weight regain.

Transformation photos typically consist of at least a pair of side-by-side photographs of a person purported to display their "progress" or "success," but which almost universally display weight loss over time. Sure, weight loss can be a kind of progress, even if that means progression through an eating disorder, physical illness, cancer, depression, or poverty. But the reasons for weight loss never seem to matter since becoming smaller is so widely viewed as a positive change.

You cannot determine health based on appearance.

In my case, any transformation photos I could post would show obvious weight gain. What they don't show is my recovery from disordered eating habits, untreated depression, over-exercising and under-fueling. Nor do they show that I've completed two half marathons, a 15-mile obstacle race, and several triathlons since I've begun running. They can't show that I've become stronger, fitter, faster, and far healthier since gaining ≈15 pounds (≈half muscle, half happiness) over the last 5 years. 

Weight change does not show wellness.

It's not petty envy at being unable to effectively participate or receive feedback and admiration that fuels my irritation with transformation photos. It's frustration that body size is used as a measure of success without regard for any person's actual health or positive changes in wellness. It's the widespread belief that weigh loss is the ONLY measure of success and that without seeing numbers on a scale decrease, one can only be a failure. Even moderate weight loss is seen as a failure if one hoped to achieve more. This is the message blanketing so-called "health" and lifestyle magazines, TV ads, "inspirational" fitness memes, gym walls, and "fitness" forums.

Body size does not indicate health.

What if instead of posting weight change and body measurements with "transformation" photos, we captioned them with accomplishments such as strength increase, distance goals met, increased energy levels, lowered blood pressure, and improved emotional health? These are things more people can pursue and control, goals more inspirational than statistical outliers largely dependent on genetics and starvation-levels of caloric restriction. Actual measures of health and wellness rather than shallow and false substitutes for health.

Unexpected Side Effects

As a privileged, university-educated, straight-size, fit, able-bodied, middle class, white woman, I would like to whine that my frequent posting about fat acceptance, body positivity, anti-dieting, feminist, activist, and related topics seems to make some men think I'm insecure and soliciting validation when I'm really just spreading information and ideas.

Logic brain understands that these men are tone-deaf and simply don't understand any of the actual issues I write about and probably cannot without endeavoring to do difficult mental gymnastics. Jerkbrain now worries that I come across as insecure and weak and will make me think twice about all the things I post going forward.

Ironically, it's when others declare themselves the expert on my lived experience by telling me I'm insecure that makes me feel unsure of myself. I never knew I had a poor body image or poor self-esteem until men told me I did and patronizingly lectured me about inner beauty and offered their unsolicited opinions to validate my appearance and self-worth. (The fact that their actions were well-meaning does not change or conflict with the previous statement about them.)

A friend once messaged me privately with a page-long lecture about beauty, acceptance, and self-worth, in response to my many fat acceptance posts on Facebook. I explained to him that:

I’m fueled by a lot of anger at having spent most of my life swallowing the message that I'd have to spend the rest of my life battling my weight in order to be happy, healthy, wealthy, or loved, and so much anger that so many others continue to believe this.

Beyond just posting links on my own page and seemingly yelling a lot, I frequently engage in discussion in private groups about weight, health, and beauty with women who haven’t heard it yet and are grateful when they do. (And am also contributing a chapter to an anthology of perspectives on the fat acceptance movement.) 

Personally, I’m bored to death of being told I’m physically attractive, especially by men who are often clearly expecting my gratitude for their thinking so. I know I’m conventionally attractive; it’s boring. I didn’t earn it and don’t feel complimented. I don’t want to settle for reaping the benefits of my privilege without a though and I don’t want a world in which women of different sizes, abilities, colors, etc., have to accept that bigotry either. 

I can silently work to accept that I will never be a "normal" or a "healthy" weight according to the "experts." Or I can teach and remind everyone that BMI is not an indicator of health and should not be used to make policy, and I can influence the attitudes and opinions around me and ultimately convert everyone I know to the "Yay fitness!" party and not have to hear about diets and weight loss and body shame all around. 

I didn’t always know these things or feel this way; I came to them by reading and learning, and others will, too.

Ultimately, we realized he had meant to ASK about my feelings on the subject but in a strange misfire had ended up TELLING instead. Apologies were made and accepted and life went on.

Months later, I posted a selfie with a sign about setting a distance PR in the pool and completing a "Fit Fatty Virtual Event." I received a comment on the photo from another male friend along the lines of "I know you're insecure, but I don't consider you fat, and the people who know you know you're beautiful. Blah blah blah patronizing validation blah blah."

I responded with:

Alternatively, you could ask me what the Fit Fatty thing is about instead of projecting assumptions onto me. It's the name of forums and a Facebook group that are weight-neutral places to discuss fitness from a Health at Every Size perspective and are hosting a virtual decathlon event this year, which is why I'm posting the pictures. 

It's exceptionally rare to find communities where we can discuss fitness free from weight loss and diet talk.

And he deleted his comments before anyone else could see them.

I question whether my response was appropriate, too harsh, or too soft for the comment and the person and whether I should also have added:

1. I'm not fat. I know this and don't need you to tell me so.

2. There's nothing wrong with being fat and I genuinely look forward to the day that I fulfill my dreams of growing up to be a jolly, round Hobbit. (I come from an overwhelmingly obese family [no value judgment, just a fact]; it's really only a matter of time. But by then my body may be able to support competitive amateur weight lifting, and how cool would that be? /tangent)

As often as we think of the perfect comeback far too late, I think I did alright and managed to hide and overcome the shock and hurt feelings that the original comment triggered so suddenly and strongly.

Regarding this, a woman friend pointed out: 

Many women are insecure. Many women fish for compliments; not necessarily consciously. Men develop certain habits and assumptions in response.  

Mentioning weight, shape, diet or exercise is likely to trigger these habits more often than it triggers actual thought about what you posted.

I can't keep myself from judging people who fail to think before speaking.

Things that might have influenced such a bizarre, presumptive, and invasive comment:

I don't feel like I need to explain posts promoting equality, body positivity, size acceptance, healthy behaviors for all people regardless of body size, not judging people based on appearance including clothing size, etc.

When I complain (often at great length) about the obscene prices of gender-specific underwear required for exercise due to my apparently abnormal and grossly misproportioned body, nothing in that complaint is directed at my body. I'm angry at apparel makers for only catering to a paper-thin range of body types and I'm angry at the patriarchy for the fact that good sports bra designs don't even exist and I'm angry at both that I have to spend a minimum of $70 on an essential piece of clothing to support my running and fitness endeavors that only works because I happen to run slowly anyway.

My body is just lovely, but I could write a book about issues of access to safe, enjoyable forms of fitness and even finding exercise clothing in the necessary size, much less being able to afford it. (I wish I had time to write a book. That would be a good book.)

I said this about a photo taken immediately after running a fast mile:

"I fucking hate photos of myself working out and am this close to quitting the challenge because of the photo requirement."

When I complain about photos of my running and post-running because my hair is disheveled, my face flushed, and my body pouring sweat, it's really not a cry for validation and definitely not part of an overall trend of complaining about my appearance. Even as an advocate for body-positivity, surely I am allowed to despise gym and fitness selfies? Or do I have to love and brag about my appearance ceaselessly? I'm certainly capable, but it wouldn't be real and I'd probably lose a lot of friends.

I wish I had some snappy way to wrap this up: Think before you speak, learn to recognize a request for help or reassurance when there is one instead of reading it into random statements and offering help unsolicited, and just fucking Google it.

Emotional Eating is OK

And more than that, it's a good thing and a useful coping mechanism. I'm an unapologetic emotional eater.

The Fat Nutritionist explains:

. . . to be honest, eating is inherently emotional. First, in the sense that it provides us pleasure, otherwise we probably wouldn’t take all the time and effort to find food, prepare it, and eat it. Because it is so essential to our survival as a species, it has, of course, become embedded in our brain’s pleasure-pathways as something intensely enjoyable (much like, ahem, other species-propagating activities.)

So whether you think you’re eating for emotional reasons or not, whether you’re doing it intentionally or not, all eating is fundamentally emotional. (emphasis hers)

Depression and anxiety run rampant in my family and are things I manage well enough through exercise and creative endeavors. Denying cravings, food moralizing, and worrying about getting fat does nothing to promote health and in fact creates needless anxiety and stress. Alternatively, emotional eating both allows us to celebrate and to cope.

And this more than some feel-good personal opinion. These conclusions, I just learned, are also supported by research (link and quote from Dances With Fat):

Stress eaters should not be considered at risk to gain weight by default. Our results suggest the need for a dynamic view of food intake across multiple situations, positive and negative. Furthermore, our findings suggest rethinking the recommendation to regulate stress eating. Skipping food when being stressed may cause additional stress in munchers and could possibly disturb compensation across situations. 

Within the framework of Health at Every Size, the practice of intuitive eating allows, encourages, and accepts emotional eating. Food alone won't solve any emotional problems, but it can help us calm down enough to do the work that's needed. Mindless eating and frequent over-eating won't do, but paying attention and thoroughly enjoying every bite can soothe and take the edge off. Eating slowly and savoring also helps us calm down and breathe. Michelle offers a guide for doing emotional eating well:

Remind yourself that eating is morally neutral – you are not doing something “bad” by eating delicious food. You are simply being human.

Eat the food. Pay attention to how it looks, smells, and tastes, how it feels in your mouth and throat, and how it settles in your stomach. Give yourself the mental space to just have the physical experience of eating.

This is just an excerpt; the whole list is worth reading. Know that emotional eating is not inherently bad, nor is any kind of food. Context matters, and moderation. Moderation needn't mean restriction but can be attained through permissive eating of a wide variety of foods and paying attention to how they make you feel. It rarely comes naturally and may take months of practice before it does. Even then, we all "mess up" occasionally, but health is a journey, not a destination.

Normal eating is being able to eat when you are hungry and continue eating until you are satisfied. It is being able to choose food you like and eat it and truly get enough of it – not just stop because you think you should. Normal eating is being able to use some moderate constraint in your food selection to get the right food, but not being so restrictive that you miss out on pleasurable foods. Normal eating is giving yourself permission to eat sometimes because you are happy, sad, or bored, or just because it feels good. Normal eating is three meals a day, most of the time, but it can also be choosing to munch along. It is leaving some cookies on the plate because you know you can have some again tomorrow, or it is eating more now because they taste so wonderful when they are fresh. Normal eating is overeating at times; feeling stuffed and uncomfortable. It is also under eating at times and wishing you had more. Normal eating is trusting your body to make up for your mistakes in eating. Normal eating takes up some of your time and attention, but keeps its place as only one important area of your life. In short, normal eating is flexible. It varies in response to your emotions, your schedule, your hunger and your proximity to food. —Ellyn Satter

No-Scale November

I am sad now that I forgot to write about this sooner. I saw someone on Facebook suggest No-Scale November, and I quickly jumped at the opportunity and recruited more friends to join me. The plan is to go 30 days without weighing ourselves (or to look the other way if we must at the doctor's office).

Though I've been practicing intuitive eating under the Health At Every Size (HAES) paradigm for about a year and have no intention of losing weight, even with all my intense exercise, I've still been weighing myself several times a week to prove that I'm doing it "right" and maintaining. There's no reason for it, and though it didn't influence my mood much, it was a waste of time and thought when I could be doing anything else at all.

No-Scale November provided the perfect reason to stop.

I weighed myself on Halloween, saw the number in my usual range, and have since forgotten it. I noticed this month that I've spent less time thinking about my body and more time admiring it in the mirror. I don't believe that it's undergoing any significant changes (I've been eating the same and exercising less), but I do like it more the more that I see it. Rawr.

I didn't know if I would weigh myself again on Dec. 1 to "prove" that I can eat "right," but I had a cool idea of shooting some pictures of my smashing the scale with a hammer for fun and art. Then I had friends who wanted to do it, too, so a few of us are taking No-Scale November a step further and having a scale-smashing party in the first week of December.

But isn't that a huge waste of perfectly good items that could be donated?

Uh, no. Scales don't make people happy and I'd feel sorry for whomever got mine, which was less than $10 from IKEA some years ago and will now serve its higher purpose as capital-A Art. I'll post pictures!

I'm not going to buy a new scale (even though I'm passingly curious about my body fat percentage and whether it's changing the more that I exercise), nor to I regularly check my body measurement or plan to start. The fit of my clothes is all that I need.

Food

I don't typically talk about food because I am very strongly anti-diet-minded* and find that the mere thought of trying to eat healthier or cut out sweets is a surefire binge trigger. I used to count calories in college, and it made me an obsessive, neurotic, hangry beeyotch, because I'd heard so much about the number of calories a woman is supposed to eat, and those advertised numbers are all for dieting and never for health. It's absolutely amazing to learn how much I'm really supposed to be eating. Though individual metabolisms vary greatly, an Internet calculator told me that for my gender, age, height, weight, and activity levels, I need ~2,300 calories per day. That is so much food!

I really like food. I discovered Health At Every Size late last year through The Fat Nutritionist's blog and very seriously took to heart the practice of intuitive eating with an emphasis on permissiveness, meaning I get to eat whatever I want whenever I want as much as I want and trust my body to tell me when enough is enough. It means that sometimes I eat a little too much and feel too full, and sometimes I eat too little and have to make an extra meal. I get to enjoy food, all kinds of food, without fear, guilt, or anxiety.

Few things piss me off as much as food moralizing and comments about "earning" or "deserving" treats. You don't "earn" food; you require it to sustain life! Our relationships with food, as a society, are fraught, and I am hellbent on finding my way to normal eating, eating that doesn't rely on calories, grams, points, or earnings, eating a variety of enjoyable and life- and health-sustaining foods that support mental, emotional, physical, and social wellness.

One obstacle, though, is that I don't cook. I don't know how and don't have an interest in it. Sure, cooking is super fun and easy for lots of my peers, but it's not really something I enjoy. It takes a lot of time, planning, and preparation. It means I eat a lot of frozen foods, fast food, and cereal.

In the last six months, however, I've learned to use my roommates' slow cooker to make one helluva spicy turkey chili and bumble through various soups and stews with edible success. I dine out once or twice a week and always get a to-go box for the leftovers, which frequently are enough for another two meals.

I also started buying sandwich fixins to try to save money on groceries, even though sandwiches are SO dry and boring. But there is a panini press in my office, magically transforming dry and boring sandwiches in to hot, melty goodness.

As an endurance athlete, I recently rekindled my love for bagels and have been enjoying the hell out of them for breakfast most days. Say what you want about gluten-free, low-carb, no-dairy diets, but I have substantial daily caloric requirements to meet. That's not to say that I'm counting calories anymore; I'm eating when I'm hungry, which is frequently. And you know what? I've been maintaining my weight all year (even with increased mileage for Savage and Spartan training) and getting faster and stronger all the time

TL;DR
You should eat in a way that makes you happy and feel good. Dieting doesn't do that for me; I like and choose to eat anything and everything I want.



*"A panel of experts convened by the National Institutes of Health determined that "one third to two thirds of the weight is regained within one year [after weight loss], and almost all is regained within five years." More recent review finds one-third to two-thirds of dieters regain more weight than was lost on their diets; "In sum," the authors report, "there is little support for the notion that diets lead to lasting weight loss or health benefits." Link

Why I talk about weight and health and Fat Acceptance so much

I’m privileged: I’m a 26-year-old, college-educated, middle class, straight-sized, cis-presenting, pretty, white woman. But I have been the victim of body shaming and mocking and direct insults from strangers and from family. I was told flat out last year by a brand new doctor who asked nothing of my food and exercise habits to lose weight. I had just run 3 miles that morning and was devastated and, of course, fired her.

Health at Every Size (HAES) and FA are important to me because every female member of my family (and most of the men, too) is obese and has been for the vast majority of their adult lives, excepting only me and my sister, probably because we’re the youngest and in our mid-twenties. I spent 25 years swallowing and dwelling on and obsessing over the message that I will spend the entirety of my life—DECADES—battling my weight, battling my genetics, waging war against my weak and traitorous body, and spent too much time blaming my family for their weight and my inevitable fate, before finding HAES.

I gave up calorie counting after college because it made me neurotic and obsessive and cranky and a miserable person and it probably qualified as disordered eating. And I was one of the “lucky” few who could easily manipulate my weight through exercise alone and enjoyed doing it. Weight loss has always come easily for me; maintenance has not. Since college, I’ve been bouncing back and forth within a 20 pound range and thinking that was normal. It’s not. It’s normal in that it aligns with most (95%) people’s  experiences with weight loss and gain, but it is not healthy or natural. Weight cycling does one more harm than being heavy.

I gave up restricted eating last year after reading a blog post from The Fat Nutritionist that outlined the exact cycle of just thinking about restricting a food triggering a binge response. The concepts of permission and intuitive eating allow me to eat better overall and enjoy every minute of it. Would you believe that I quickly dropped 5 or 6 pounds going into the holidays when I quit working out and began eating all the goodies I wanted after having maintained a steady weight for a few months? Having a healthy relationship with food means appreciating not only its nutritional value, but its emotional, social, cultural, and comfort values too and trusting your body to normalize fluctuations, such as partaking wholly of a holiday feast with people you love.

There is no science—NONE—to support intentional weight loss as a healthy behavior. It is NOT evidence-based medicine. And it IS, in fact, harmful. As a feminist, humanist, and skeptic, I am appalled at the cultural myths about thinness, the conflation of weight with health, and the rampant casual concern-trolling and discrimination against fat people.

And I am sick and tired of hearing everyone, especially people I care for, hate on their bodies and their weight, and of seeing their submission to the LIE that thin = happy/healthy/good/worthy.

Seriously,
Fuck You.
You’re wonderful.