Why Fat is Still a Feminist Issue

[circa 1975]

Sing along when the chorus rolls around (with apologies to Helen Reddy):

Yes I ate brown rice
And anything whole grain
Yes I’ve exercised
And look how much I’ve gained
If I have to, I won’t eat anything
I am fat
I am invisible
I am WOOOOOOMAN

The United Nations declared 1975 to be International Woman’s Year. Unfortunately, we haven’t really come a long way, baby, since then. Right now, I’m going to sidestep the whole media-generated body image issue, the glass labyrinth, the mommy wars, the “strong is the new sexy” idea (which somehow won out over my own personal favorite “smart is the new sexy” with campaign ads of slightly-unwashed-looking ladies without pedicures huddled over lab benches) and all the other complexities of contemporary feminist theory, and just focus on one little segment of how our national nutrition recommendations might have sucked the life out of women in general for the past 30 plus years.

We’ve been acting like the whole low-fat/low-glycemic/low-carb/paleo/whatever nutrition argument is a PubMed duel between scientists, and the fact that we are surrounded by lousy, nutrient-poor, cheap food is the fault of the Big Evil Food Industry. Let’s focus our attention regarding the current health crisis in America where it really belongs: on short-sighted, premature, poorly-designed (albeit well-intentioned) public health recommendations that were legitimized with the 1977 Dietary Goals for Americans and institutionalized as US policy beginning with the 1980 Dietary Guidelines for Americans.  Yes, fat is still a feminist issue.  But I’m not talking about body fat.

The scientific underpinnings for these recommendations came primarily from studies done with white men. And although the science conducted on these white guys was generally inconclusive, the white guys in Washington—in an attempt to prevent what they saw as a looming health crisis in America—recommended that Americans consume a diet high in carbohydrates and low in fat. And although these premature recommendations have certainly not prevented any health crises in America (the appearance seems to be just the opposite, see: Public Health Nutrition’s Epic Fail), they’ve also had serious repercussions in other respects for the rest of us, i.e. the ones of us who are not white men. [Please don't take this as a "I hate white guys" thing; I love white guys. I gave birth to two of them.] I’m going to get into the “not white” part of the equation in another post (perhaps unimaginatively titled, Why Nutrition a Racial Issue), but let me focus just on the “not men” part.

For those of us who are not men (and mostly not poor and not minority), the 1970’s brought us Charlie’s Angels and the Bionic Woman. Women were given the message that we should be able to do and have “it all” (whatever “it all” was). The expectation was that you could “bring home the bacon, fry it up in a pan” and be thin, gorgeous, and sexy (and white) while you did it.

[circa 1980]

Only now bacon (and eggs for that matter) was forbidden, and as the eighties evolved into the nineties, breakfast became Special K with skim milk, slopped into a bowl which we ate from while we drove the kids to school on our way to the job where we got paid less than the men with whom we worked. All the while, we were convinced that we could continue to fit into our tailored power suits by eating a diet that wasn’t designed with our health in mind.

[bacon eggs frowny face, circa 1984]

As with nearly every other aspect in the fight for equal opportunities and treatment, our health as women was based on a single shiny little myth: success would come to those who were willing to work hard, sacrifice, and follow the rules. Airbrushed media images of buns of steel and boobies of plastic sold a diet-exercise message based on an absurdly crude formula—”calories in, calories out”— with one simple rule that would guarantee success: “eat less and move more.”

So we did. We ate less and exercised more and got really tired and hungry and cranky—and when that didn’t really work, we bought treadmills and diet pills, Lean Cuisines and leg warmers. We got our health advice from Jane (“feel the burn”) Fonda and Marie (“I’m a little bit country”) Osmond. We flailed through three decades of frustration, culminating— unsurprisingly enough—in the self-flagellation of Spanx® and the aptly-named Insanity®.

[Jane Fonda circa 1982]

Some of us “failed” by eating more (low-fat, high-carb) food and getting fat, and some of us “succeeded” by developing full-blown eating disorders, and some of us fought the battle and won sometimes and lost other times and ended up with closets full of size 6 (“lingering illness”) to size 26 (“post pregnancy number 3″) clothes. All of us—no matter what the result—ended up spending a great deal of time, money, and energy trying to follow the rules to good health with the deck stacked against us. If we got fat, we blamed ourselves, and if we didn’t get fat it was because we turned our lives into micromanaged most-virtuous eater/exerciser contests. Either way, our lives were reduced, distracted, and endlessly unsatisfying.  We were hungry for more in so many ways and aching for rest in so many others, but our self-imposed denial and exhaustion allowed us to control, at least for a bit, the one thing we felt like we could control, that we’d fought to be able to control:  our bodies.

We stopped cooking and started counting. We stopped resting and playing and started exercising. We stopped seeing food as love and started seeing it as the enemy. We didn’t embrace these bodies that were finally, tenuously, ours; we fought them too.

Access to high quality nutrition has always been divided along gender lines [1].  There was a time–not that long ago–in our world when men, by virtue of their size, stature, place as breadwinner (i.e. because of their “man-ness”) were entitled to a larger piece of meatloaf than their sisters (a practice that persists in many cultures still).  How many of us (of a certain age) have heard, “Let you brother have the last piece of chicken, he’s a growing boy”?  Now–conveniently–women would do their own restricting.  Gloria Steinem, with a fair amount of prescience that seems to predict the epigenetic contributions of diet to obesity, noted in her 1980 essay The Politics of Food:*

“Millions of women on welfare eat a poor and starchy diet that can permanently damage the children they bear, yet their heavy bodies are supposed to signify indulgence.  Even well-to-do women buy the notion that males need more protein and more strength.  They grow heavy on sugar and weak on diets . . . Perhaps food is still the first sign of respect–or the lack of it–that we pay to each other and to our bodies.”

Dieting and exercising not only provided a massive distraction and timesuck for women, it helped maintain a social order where women were weak and undernourished that the feminist movement otherwise threatened to undermine.

And when the scientists finally got around to testing the whole low-fat thing on (80% white) women? The verdict, published in  2006, looked like this:

The results, published in the Journal of the American Medical Association, showed no benefits for a low-fat diet. Women assigned to this eating strategy did not appear to gain protection against breast cancer [2], colorectal cancer [3], or cardiovascular disease [4]. And after eight years, their weights were generally the same as those of women following their usual diets [5].

But it was too late. We’d raised a generation of daughters who look at us and don’t want to be us, but they don’t know how to cook and they don’t know what to believe about nutrition and they are afraid of food. Some end up drinking the same kool-Aid we did, except that—in the hubris of a youth that doesn’t contain hallucination-inducing sleep deprivation from babies and/or stress and/or a career on life-support, where diet and exercise and rest are, like Peter Frampton’s hair, a dim memory—they think they will succeed where we failed. Or maybe they’ve found the vegan-flavored or paleo-flavored kool-Aid. But they are still counting and exercising and battling.

White women have been [irony alert] scientifically proven to follow the high-carb, low-fat dietary ideal set forth by the Dietary Guidelines more closely than any other demographic [6]. (Black guys—who may not be all that convinced that rules created by the US government are in their best interests, given some history lessons—are likely to have the lowest adherence.) White women apparently are really good at following rules that were not written with them in mind and which have not been shown to offer them any health benefits whatsoever (but which have proven immensely beneficial for the food and fitness—not to mention pharmaceutical—industries). The best little rule-followers of all are the dietitians of the Academy of Nutrition and Dietetics (87% white women), who heartily endorsed the 2010 Dietary Guidelines, which reinforced and reiterated 30 years of low-fat, high-carb dogma despite the Harvard-based science that demonstrated that it offered no benefits to women. (Interesting tidbit: The Academy of Nutrition and Dietetics has elected two male presidents in the past decade despite the fact that men make up only 5% of the membership. My husband thinks the organization has “daddy issues.”)

In 2010, the American Medical Association recommended that women of normal weight (that’s less than 40% of us, by the way) who wanted to stay that way “while consuming their usual diet” (i.e. low-fat, high carb) would have to exercise for an hour a day

[Other reassuring conclusions from that study: There was an overall weight gain over the 13-year time frame. Exercising for anything less than 7 hours per week was associated with weight gain over time. If a woman was already fat, increased exercise was more likely to be related to increased weight than weight loss.  If these messages don't scream to women all over America, "GIVE UP NOW!!!" I don't know what would. By the way, those of us who go out and skip and jump and run because we like to and it makes our hearts truly happy are not exercising. We're playing. I love to wave at those women from my couch.**]

But let’s get back to that hour a day for just a second.

Take a look at a recent study by Dr. David Ludwig, out of Harvard. It demonstrated that people who had recently been dieting (something that would apply to almost every woman in America), and were eating a low-fat diet, had to add an hour a day of exercise in order to keep their “calories in, calories out” balanced, while those on a very low-carb diet expended that same amount of energy just going about their business.

What if all the women in America who have been unsuccessfully battling their bulge woke up tomorrow morning and said:

I want my hour a day back?

For those of us who do not want to exercise for an hour just to maintain our weights or for those of us for whom exercise isn’t doing a damn thing except making us hungry and cranky and tired while we gain weight, we don’t have to. Instead, we can eat fewer of those USDA/HHS/dietitian-pushed, nutritionally-pathetic, low-fat whole-grain carbohydrate foods and more truly nourishing food and do whatever we please with that extra hour.

Who knows what changes we can make to a world that desperately needs our help when around–ooh let’s just say–50 million adult women in America have an extra hour a day? That’s an extra 365 hours a year per woman, an extra 18 billion hours of womanpower a year total.

We could stop exercising and start playing. Stop counting calories and start enjoying feeling nourished. Start putting the love back into our food and embracing the bodies we have and the bodies of the men, women, and children all around us. I know that some of us would find that hour well spent just napping. Others of us might use that hour to figure out how to dismantle the system that stole it from us in the first place.

I can bring home the bacon, fry it up in a pan. And eat it.

******************************************************************************

In my own personal celebration of Asskicking Women of Food, I think (I hope) my next post will be:  The Grande Dames (Goddesses? Queens?) of Nutrition

*Thanks to Gingerzingi for bringing this to my attention.  What a great essay–look for it in a collection entitled Outrageous Acts and Everyday Rebellions.

**I have absolutely nothing against activities that bring inner/outer strength and happiness.  But exercise in the 80s and 90s was not about being happy or strong–it was about punishing ourselves (feel the burn? seriously?) in order to win at a game–being in total control of everything in our lives from babies to bodies to boardrooms–whose rules were created within the very social construct we were trying to defeat.

References:

1.  Bentley, Amy (1996) Islands of Serenity: Gender, Race, and Ordered Meals during World War II. Food and Foodways 6(2):131-156.

2. Prentice RL, Caan B, Chlebowski RT, et al. Low-fat dietary pattern and risk of invasive breast cancer: the Women’s Health Initiative Randomized Controlled Dietary Modification Trial. JAMA. 2006; 295:629-42.

3. Beresford SA, Johnson KC, Ritenbaugh C, et al. Low-fat dietary pattern and risk of colorectal cancer: the Women’s Health Initiative Randomized Controlled Dietary Modification Trial. JAMA. 2006; 295:643-54.

4. Howard BV, Van Horn L, Hsia J, et al. Low-fat dietary pattern and risk of cardiovascular disease: the Women’s Health Initiative Randomized Controlled Dietary Modification Trial. JAMA. 2006; 295:655-66.

5. Howard BV, Manson JE, Stefanick ML, et al. Low-fat dietary pattern and weight change over 7 years: the Women’s Health Initiative Dietary Modification Trial. JAMA. 2006; 295:39-49.

6.  Sijtsma FP, Meyer KA, Steffen LM et al.  Longitudinal trends in diet and effects of sex, race, and education on dietary quality score change: the Coronary Artery Risk Development in Young Adults study. Am J Clin Nutr. 2012 Mar;95(3):580-6. Epub 2012 Feb 1.

24 comments on “Why Fat is Still a Feminist Issue

  1. roberta4949 says:

    like your article, you talk about the pain and suffering of our weight battles? I can attest to it, this weight thing and suffering woman and many men have gone through was a very cruel joke to play on society. I have spent 40 years fighting a gradually increasing bulk nothing has worked so far, the closest thing that seems to be working is what stephanie seneff speaks bout sulfer, more sunshine, reducing carbs, I did low carb by the way it didn’t work, only moderate reduced carb seems to be making me feel better. I have to supplement to help be digest my food and handle glucose better, I stick to mostly whole fruit (some juicing but not often only when I crave it which is not often) salads, veggies, dark chocolate, some ice cream, but the ice cream they have now seems to be less satisfying then the past. oh yea forgot, i have had to endure the shame looks from even my friends, unsolisticed advice on weight issues, and that glaring I don’t believe you when you say you have tried to lose weight. it hurts but I keep it in because I know they don’t understand. but I do. that right there gives me comfort.

    • Adele Hite, MPH RD says:

      Thanks for sharing your story. I think the “blame” part of the situation is most frustrating. If someone is getting fatter & can’t seem to prevent weight gain–or if someone is already fat–it would be nice if it wasn’t assumed that this person–for some reason no one bothers to articulate–is doing it on purpose. When you try to lose weight and it “works,” you get all this positive feedback (You look great, etc, etc). But you can be trying just as hard, and if whatever you’re doing isn’t working, yeah, it’s those looks.

      And, I’ll confess, after starving and exercising and nothing happens? Yeah, I want a chocolate croissant . . .

  2. Valerie says:

    Hi,
    you write that the guidelines have not been proven to work for women (they actually have been proven to not work). But have they been proven for men? Or not proven to not work? I had the impression they had never been proven to help anyone (or any group of people). If the guidelines are equally ineffective for men and women, I don’t see the feminist issue (aside maybe from social pressure that seems to be worse for women).

    Thanks for you time.

    • Adele Hite, RD MPH says:

      Valerie, Good questions. There is exactly one area of which I am aware in which the Guidelines “seem” to be working: heart disease in white males. As this was one of the primary concerns with early research (heart disease in white men), there was, at the very least, a bit of hint that this dietary change might be beneficial with regard to this particular result for this particular group, although the science was still quite mixed in results during the development of the initial Guidelines.

      Let me be clear that I am talking about heart disease prevalence, as opposed to mortality–and that so far, the benefits have only been seen in white men. African-Americans and women continue to see higher rates of heart disease than were present in the early 1970s. Heart disease for women is trending downward (although still above previous levels); heart disease for blacks is trending upward. These trends are occurring concurrently with an overall decrease in smoking, blood cholesterol levels, and hypertension–which may explain the decrease in heart disease prevalence in men.

      Do we want to attribute causality to the relationship between the Guidelines and heart disease in men? I don’t, because I think causality is too complicated. But it may be worthwhile to think about how the Guidelines might have affected men and women differently, in terms of biology, social pressures, food choices, etc.

      Something that we should also be wondering about is why–during its most recent updates–the CDC no long reports coronary heart disease prevalence, for any group. Only mortality is reported. Hmmmm.

  3. BawdyWench says:

    Yes. Yes. Yes. You summed up what has been rolling around in my head for about the past 20 years.

    When I went to the doctor (read: about 10 doctors) when I had gained almost 50 pounds in 18 months without changing food intake or level of activity, I was told by a woman doctor that I should be doing aerobic exercise 1 full hour 7 days a week at maximum intensity. That’s the only way I’d lose the wegiht.

    Now, I had brought in my food journals along with my exercise charts for both weight training and HIIT cardio. Weight training was 3 times a week, and it was strenuous. Cardio was HIIT and 3 times a week. One day of rest. All she looked at was my chart for cardio, saw it was “only” 3 days a week and said I wasn’t trying hard enough.

    The whole attitude of the “professionals” that if a recommendation is not working for you, you’re OBVIOUSLY not doing it right or enough.

    You hit the nail on the head, Adele! I’ve already passed this blog on to all my female friends, and posted it on several LC forums.

    • Adele Hite, RD MPH says:

      Thanks so much for sharing your story (and the post). Sadly, many of us internalize that feeling of not doing things right (one more on a long list). It is a wonder that we keep trying at all. I met women in clinic who had essentially been dieting their entire lives (unsuccessfully, which is why we were seeing them). It never stopped hurting my heart to hear their stories.

  4. Franziska says:

    Another brilliant post, Adele! You’re the best :)

  5. Alicia Lacovara says:

    Brava! Love your work, keep it coming!

  6. wendyrg says:

    Oh what a wonderful post. Yes, that extra hour a day could be used for so many things…and so many subversive things like fighting for universal health care or the right to make our own decisions when it comes to reproductive health. Yes, so many things.

    I also really like what you said about “punitive” exercise. I really don’t think much has changed since the 80s. All you have to do is watch an episode of The Biggest Loser (I’ve only watched it once and what I really wanted to lose was my lunch–The Biggest Sadist, anyone?) or read some of the weight loss blogs out there to see how much hatred of fatties and desire to see them suffer (exercise til you drop) there is out there.

    It’s flabbergasting how women have been totally ignored when it comes to diet (as in: “what we eat”), weight loss/gain/maintenance and exercise. Our bodies are so incredibly different from men’s, even when we’re of the same ethnic group or social class, etc.

    If you’ll permit me a funny little n-1 anecdote: Over the past 25 years, my husband–who wasn’t slim in the first place–gained more and more weight. He wasn’t eating a “bad” diet or a SAD diet, just fruits, veg, meat, whole grains, a few treats now and then, but really there was nothing terrible about what he ate. After years of my begging him, he finally went to the doctor for a check-up and came home with a prescription for a low dose of diuretics for slightly high BP. He didn’t mention anything else about what the doctor had said, just that he had another appointment a month later to see how things were going.

    During the course of that month, I noticed that he made a few minor changes: he stopped drinking his one small glass of unsweetened juice night; he almost entirely stopped going back for seconds at supper, though his portion sizes didn’t really change; he began drinking more water; he got on the elliptical trainer twice a week for about 1/2 hour at a time while watching TV. Really, there were no huge changes, though.

    And wouldn’t ya know it? In a month, he lost 11 pounds. He’s continued with these new habits. He refuses to weigh himself and is still on the heavy side, though you can tell he’s lost weight. He feels good in his own skin. He still takes that low dose of diuretics.

    I don’t drink juice in the first place, I drink lots of water, I’m pretty good with portion control. The only thing I can’t do is engage in strenuous exercise due to I arthritis, which I inherited from my wonderful mother and which I began developing in my twenties (it’s a family thing, sadly). And wouldn’t ya know it? Losing and keeping off just a few pounds is an enormous, nay sisyphian, undertaking.

    Personally, I attribute these differences mostly to gender.

    Now, would I be better off on a low-carb diet? I really wish I could meet with you for a personal consult. My tendency–after trying every cockamamy diet out there when I was younger and thought I could tame the weight beast–is to eat mindfully and moderately and try and let my weight settle where it wants. I am just not ready to turn my and my family’s life upside down by ridding the house of every crumb of artisanal bread. It would feel too much like never-ending Passover (a Jewish joke).

    There, I’ve kept you too long.

    Thanks again for a great post. I’ll be adding you to my blogroll (newme-freshstart.blogspot.com–if you have time to drop by).

    • Adele Hite, RD MPH says:

      Wendy, Thanks for sharing your story. I’ve always been amazed at how little we acknowledge (or are willing to recognize) gender differences in nutrition (along with other subpopulation differences). I’ll read a “definitive” meta-analysis where, when all groups are mixed together, the overall associations are actually quite different than they are for subgroups, especially older women.

      It’s so nice that you’d like to meet for a consultation, although it sounds like you are doing well on your own. I do plan to begin seeing clients in the near future, as I really miss the patient interaction which was always the best part of my job at Duke. I’ll be sure to make an announcement here. In the meantime, as I post some of the “self-help” nutrition stuff, please let me know what you think. And you can always email me: adele.hite (at) gmail.com.

      Would you be “better off” on a low-carb diet? Not if it felt to you like never-ending Passover! I’m afraid when I do start seeing patients, they’ll run away screaming when I tell them how much work they have to do (figure out your own health goals, figure out what you are/aren’t willing to change/negotiate–although I can help with information and guidance) and how little I really know (because you are your own best expert).

      Thanks for adding me to your blog roll–I’ll be sure to drop by.

  7. Sidereal says:

    Fantastic post, truly. I’ve recently discovered your blog and have been reading the archives.

  8. I have the Gloria Steinem book in the house somewhere – I am going to read it this weekend. I loved this post, the sharp end of the diet wars.
    This is where it gets interesting.
    Because it’s not always about the science. It’s about what’s happening to us, and maybe the science can’t always explain that, or if it does, it can’t confirm that the explanation applies to everyone.
    And maybe what people knew in the past is at least as important as the latest disposable findings.
    Just when I thought I had nothing left to read!

    • Adele Hite, RD MPH says:

      Great point–it isn’t always about the science, or even about the policy, but what happens to actual humans when those things interact.

  9. tess says:

    OMG, there’s another Tess out there! ;-)

    Adele, another great article! i posted it on FB today — i sure hope all my female friends and relatives read it!

  10. Tess says:

    I distinctly remember the first time that I got off a scale and decided I needed to try to lose weight. I was 5… 5 years old! That traumatizing scale experience set off 20 years of thinking that I just wasn’t trying hard enough (before discovering that the low-fat dietary guidelines were not gospel).

    This is such an important message to get out. Thanks Adele for the well written and powerful post!

    • Adele Hite, RD MPH says:

      5 years old! I would be more horrified if I hadn’t heard similar stories in clinic. The more we learn about the obesity-disorder eating continuum, the more the “eat less, move more” prescription looks like we’re just asking for trouble. Thanks for the kind words!

  11. Zanjabil says:

    I so enjoyed this post!

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