Episode 80 Transcript

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Welcome to the Fierce Fatty Podcast. I'm your host, Victoria Welsby and this is episode 80. Today, we're talking about am I going to die soon (er) from fatness and what about our knees!?

I'm Victoria Welsby TEDx speaker, Best Selling Author and fat activist. I have transformed my life from hating my body with desperately low self esteem to being a courageous and confident fifth party who loves every inch of this jelly. society teaches us living in a fat body is bad. But what if we spent less time, money and energy on the pursuit of thinness and instead focused on the things that actually matter? Like if pineapple on pizza should be outlawed? Or if the mullet was the greatest haircut of the 20th century? So how do you stop negative beliefs about your fat body controlling your life? It's the first fatty podcast Let's begin.

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Hello, fatty Welcome to this episode. How are you doing? How's live you feeling good? I hope you are I am today and feeling anxiety

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I Oh brain Why are you feeling anxious brain I got some I got some drug the government drugs I'm trying this new

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CBD gummy like the candy like sweeties sweeties and I got a CBD one on I got a THC one which is the CBD just doesn't make you doesn't make you high. It just changes you know shooting your brain don't ask me what it does what it does to your brain but yeah, so it doesn't make you high but the THC one the THC gummies do make you high. And so anyway, I have not taken the THC one this morning. But I've taken a CBD one to try and stop this anxiety that's going on in my brain right now. Yeah, I noticed what I'm getting into, like, my brain is being anxious when I'm, I'm ruminating on, on on things that I can't control about thinking about how people are perceiving me, and whether I'm a good person. And normally my brain is able to just think about that and be like, You know what, you can't control what people do. And, you know, you know what you read about you're a pretty good person, but of course your human being you make mistakes, but you know, just try and do good and don't stress about it. But then when my anxiety is kicking in, it's like you're about to be canceled. Everyone thinks that you're a bigot. And is that true? Hmm. Sounds like anxiety. So yeah. So I I'll be feeling better soon.

And anyway, talking to you talking to you. Talk to you like my brain knows I'm like, Doctor, you will make me feel good anyway as well. And anybody think about like, a couple of nights ago, I took a CBD gummy gummy and I took a THC gummy. The THC one is the one that makes you high and CBD makes you makes you relaxed. And so I took both of them together. And don't don't do what I do. Like just because that works for me. Doesn't mean that that's gonna work for you. Like don't do drugs just because I am. Anyway, I took took these and I started watching funny videos.

And I this is one funny video, which is, you know, there's a few funny videos that you just remember and you just go to and yeah, so I started my YouTube funny video hunt with one of my most favorite funny videos, which is, if you've not seen it, I'm gonna leave the link and actually, I'm gonna see if we can put it in the episode and hopefully no one's gonna claim copyright or something. I think it's I think it's okay under fair use to share this clip so let me share this clip with you. So the clip is a police officer has stolen Marijuana that he's obviously in the police station or whatever stolen it took it home, and he made a brownie. And him and his wife called the police afterwards and was like, I think we're dying. So my favorite line is, I don't know. We made brownies. And I think we're dead. And time is going by really, really, really, really slow. I can funny. Oh my god. Yeah. So here's that clip to lift your mood.

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A councilman from Dearborn, Michigan is outraged over a 911 call. He wants to know why no charges have been filed against a police officer who admits to confiscating marijuana from suspects and then baking it in brownies. And once he and his wife were full and high, they thought they'd overdosed and called 911.

5:55

I think I'm having an overdose of my wife, overdose of what marijuana? I don't know if it had something in it. Can you please send rescue? If you guys have fever? No, I'm just, I think we're dying. How much did you guys have? I don't know we made brownies. And I think we're dead time is going by really, really, really, really slow.

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Well, instead of being charged, Perla, sorry, instead of being charged, the police department let the officer resign. His wife was not charged either. So far, police officials have not commented on the case. So

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how do you follow a story like that? We'll talk about switching switching gears time is going by really, really slow.

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So there you have it. Just and the fact that he is a he's a cop, just it just like it's just sweeter, right? It's just sweeter. Yeah, so do go my dog. Because apparently, you've told me that you like hearing about duple and the Doogal content, you really like it? And I'm like, really? I feel like I'm forcing my love of duchal the dog on to you being elected me and it'll sound amazing. But do you remember last episode I told you he was he's gonna have a walker. But he's been on two walks with his walker, and first walk. So I gave him to the walker. And the Walker was like, Oh, you just you just slip away. And I like slipped away. And Google was like, looking around for me like, Well, where did you go and as I was fully expecting a call for or a text from the trait from the walker being like, um, he's refusing to move, you have to come and get him. But for an hour, he was good. He they didn't manage to go a block. They just paced kind of back and forth in front of my building. Google was trying to find me in the garbage area. So he was like, Okay, maybe that bitch has gone to the garbage area, why she trying to run away from me.

And then he would go around the other side to see maybe I'd go on the other side. But in between that he was getting lots of love from the trainer from the walker. And when I came back out, Dougal was that licking his face getting pets from him and no one no one who doesn't know de Gaulle can touch him. And even if people know him, you have to kind of build up and because he's he's he's a he's an anxious dog just like me. And so yeah, I can't believe it. And then yesterday he went out again, and he got 30% Further this time, so didn't make it around a whole block but did a little bit better in that because the trainers the the Walker is like, I don't want to force him which is which is beautiful. And yeah, so And Danny was on his knee and kissing him and all that type of stuff. So maybe in a month's time they would they actually they will actually get to go for a walk an hour long walk because right now it's just one lever walking but just back and forth in front of the house. So that's an update on Dougie volume.

Another another update? I did an episode maybe 510 episodes ago which was about trauma and are we fat because of trauma and something else that I found out about that just a little like an add on to that is something else I found out about the idea of like where did that idea come from? I didn't mention it in the episode The idea of fat people of fat because we experienced trauma and we are we consciously or unconsciously make ourselves fat to avoid to deal with trauma or or avoid being noticed and and listen to that whole episode because this is a very nuanced topic and, and but this basically, it's not. There's no evidence to really show that and also, I mean there's things called adverse childhood experience. aces, Aces. And there's a lot of there's research there about adverse childhood experiences. And it means that people who have had adverse childhood experiences are more likely to have physical ramifications, like in regards to their health status later on.

Anyway, but the i This whole idea, but what I'm saying is, it's not true for most people, but there are, of course, there are some fat people who, consciously and unconsciously say, I'm going to be fat to protect myself. And that's fine, you know, no judgments there. But the origins I learned is that a lot of these ideas came from came from Sigmund Freud, Sigmund Freud

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is an was an Austrian neurologist and the founder of psycho analysts. He was around from 1518 56 to 1939. So he's like, you know, who Freud is like, that's like, it's kind of like pop psychology. And so he said, loads of different physical illnesses, were actually due to repressed psychological wishes and desires. So he says, illnesses are a manifestation of things that are going on in your mind. And he said that, that people, especially women became sick in order to not have sex or be seen as sexual. And so that is, from what we know, kind of where, like, he didn't say fat people are fat because blah, blah, blah, but the idea that maladies are caused by what's going on in your brain, which is a cause, like, you know, it's like all these new New Age woowoo like, oh, you manifested having cancer. And, you know, if you have good thoughts and your cure your cancer, like, oh, you know, all that type of bullshit, which is, which is bullshit.

And so, and then in the 1980s 90s 2000s, there was a lot of discussion around this, particularly, Janine Roth, who wrote the book, woman, food, women, food and God, and Susie Orbach, who wrote fat as a feminist issue. Both of those books were talking about how we eat our feelings. And and fatness is a manifestation of trauma, that type of thing. So just a little side note there, a little history, a little history for you a little sprinkling on health, or if you're there, I thought that was interesting. And I remember I read both of those books when I first read started, and when I first heard the concept of of that positivity, I remember reading both of those books. And neither of those had any red flags for me at all, because I was new in understanding this stuff. And I was just like, yeah, totally. I believe what you're saying in this book, and I it sounds and it makes sense. And now I went back and read the, the, you know, the back cover and the synopsis. And I was like, Whoa, fuck no. I think the was it, Suzy Oh, back to one was something like,

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what we have on our plate is a huge is a universe of everything that we everything that we eat is a representation of everything. And I was like, No, man, like some No, no, no, no, Suzy. No, you just stopped that. So yeah.

Now today's episode, is from it. We're talking about a question that I got. So let me read out that question for you. And this is a question that I get often not this exact same question. It's not like one person keeps sending me this question. If I go away, if there's this question, a version of it, I get, I get often and so I was like, uh, you know, I need to make a second episode about this because then I can point people to the episode, and hopefully it is helpful. So this is the question. I am new to the first party community and I've been trying to explain things to my husband. He is on board, but he has some hangups. He's very science minded and research oriented. I was wondering if you could point me in the direction of resources explaining how football fat does not equal unhealthy. He has a brother who is in a larger body and has knee and ankle problems and his diabetic, which my husband attributes to his weight, or attributes. Am I saying it in an open a North American way, or the British way, attributes, attributes, which are his husband attributes to his weight? When I point out that he's not very active, he says that body builders and sumo wrestlers don't live very long because, quote, their hearts aren't made to support that much mass. I don't know how to respond to this. And truthfully wonder, is there any truth in this? Do you have any resources that may clear this up for us? Yes, I do. So, content warning, everything that I'm from, like from here on out, I'm going to be talking about studies.

And some of the studies, all of the studies have the mention of Oh words. A lot of them have stigmatizing language. I'm obviously going to censor that out from here. But also, I'm going to be talking about specific weight specific numbers, and height ratios. Because I'm going to do this, there's a calculation thing at the end that I'm going to share with you, which is going to blow your beautiful noggin. So just a content warning. If that's not feeling good for you today, then skip this episode, but if not, let's do this. So the question here is, he's very science minded. I was wondering if you could point me in the direction of any resources explaining how fat does not equal unhealthy? Well, the good thing is that we have an absolute abundance of evidence to support health every size to support. not stigmatizing fat people to support the idea that you can't be fat to support the idea that you can be healthy and, and fat. And that body size does not mean that you're about to spontaneously combust. So yes, we got the science, we got the science. Now there's, there's this there's so many studies, but I'm just I'm just picking out a few in this in this episode, and I'm going to link to them all in the shownotes the show notes you can find first party.com forward slash 8080. So first aid.com, forward slash 0804, episode 80.

Okay, so first study that I want to share is called the title of it is relationship between low cardio respiratory fitness, and mortality in normal weights, quote, unquote, overweight and quote unquote, obese men. So this study, which I'm going to be sharing the link to, shows that if you engage in Health, promoting activities, there's a bit quote unquote, under that health promoting activities, then your mortality rate is pretty much exactly the same across all the PMIs. So this particular field, this particular study is a study of 25,714 Sis men. So that's, that's, that's one thing to note is a lot of law, a lot of studies in all areas are not good at including

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lots of different identities. And this one is just sis men. And so we don't have any information on women or traumas don't gender folks or non binary individuals, just FYI, there. So what the study found is, if someone does 170 minutes of exercise a week, then there is pretty much no change in mortality rates across BMI. And if they did an exercise, there was an increased risk. But that increased risk with the higher BMI for those who didn't exercise this increased risk of mortality is we don't know what that is like we don't we we can't say it's because they have more adipose tissue or fat tissue on their body. So and So basically, if you are a sis man, and you exercise for 170 minutes a week, it has no difference on outcome, mortal mortality outcome. That's the first study and it's It's really like the the difference as well, even if you do, if you don't exercise for 270 minutes a week, the difference between being unfit and, quote unquote, normal weight is not that big. Anyway, so it's not like it's skyrocketing through the roof. If you have a fat body and you also don't workout, it's all it's all just very similar. Hmm, does that mean that it's not about the fatness on their body? Okay, next study that I'm talking about is it's called Healthy lifestyle habits and mortality in quote unquote overweight, and quote unquote obese individuals Matheson Al, so this study of 11,761 Sis men and women, they include women in this one.

Again, no other gender expressions showed that the more quote unquote healthy habits you engaged in men that the risk of mortality was pretty much the same, no matter the BMI. So the habits that they reviewed, what the the different habits ever reviewed work. And just by the way, if you're these I say, quote, unquote, healthy habits, these are not universally healthy. So the first one is five servings of fruit and vegetables a day. Like imagine if you had gastro intestinal issues where you couldn't eat fruit and veg, well then this would not be a healthy habit for you to engage in. So just a bit kind of Asterix there on healthy habits like it's not gonna miss not a blanket statement. So the habits they reviewed where do they eat five servings of fruit and veg a day? Do they exercise more than 12 times per month? Do they drink alcohol up to one time a day for sis women and to two per day for sis men. So the Do they not drink alcohol so they can have as much up to one drink a day and nonsmoker to being a nonsmoker. And what they found was the there were no changes in regards to there was there was no significant risk more risk if you lived in a the fattest body and engaged in healthy behaviors, quote unquote, healthy behaviors. And so the more healthy behaviors engaged in the, the smaller the difference between BMI categories, and of course, BMI is bullshit. But it sounds like again, another study to show that it's not actually actually the weights that makes someone unwell. It's if they are engaging in things that

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might support their health. Oh, interesting. Interesting. So next one I want to share this one is called the epidemiology of overweight, quote unquote, and out quote unquote, obesity, public health crisis, or moral panic. So this study, this is a quote from it. Most epidemiological studies estimating the relationship between body weight and mortality do not control for fitness, exercise, diet quality, weight Cycling, Diet, drug use, economic status or family history. Furthermore, in studies that control for some of these factors that data data are usually self reported and thus extremely questionable reliability. By contrast, when one or more confounders are controlled for in a rigorous fashion, the already weak association between higher body mass and greater mortality tends to be greatly by contrast, when one or more confounders are controlled for in a rigorous rigorous fashion, the already weak association between higher body mass and greater greater mortality tends to be greatly attenuated or disappear altogether.

For example, all of the excess mortality associated with quote unquote obesity in the fremington study can be accounted for by the impact of weight cycling quote unquote obese fremington residents with stable body weights were not at increased risk. The same result has been obtained in n Haynes. So, basically, if you take into consideration if someone has their, their fitness levels, their, what their their history of dieting is or they have done a lot of yo yo dieting, their, their economic status, their their genetics, all that type of stuff. If you strip that all away and just look at weight. There there is tiny differences between weight and death. Okay, so something in that question that was interesting is the anecdotal evidence that this person's husband uses is that he says this is a quote from it. He says that bodybuilders and sumo wrestlers don't live very long because, quote, their hearts aren't made to support that much mass. So this is anecdotal evidence there. Do we have any rigorous studies that show that sumo wrestlers and bodybuilders die at a younger age? So? Not that I'm aware of? And if there were, what are all the other factors that could cause someone to die or not be healthy, also taken into consideration? So it's anecdotal. It's anecdotal evidence to say sumo wrestlers die really young because they, their hearts can't carry that much weight. There's no evidence, like, you know, there's just fat phobia, right? It's just there's no evidence to support that. And you can like, well, I know. There's this wrestler who died. You don't know why, like, I was watching a program the other day and it was like, you know, sad things. And I was watching this sad things.

But this wrestler there was a really, really famous wrestler in the 80s, or 90s, and he fell from the ceiling, like live on TV and he died. And so it's like, well, you know, if he was fat, where people could people be like, wow, look, he's fat. His body couldn't handle that his heart just gave out. No, he had an accident at work, and that's why he died. And so sumo wrestlers and bodybuilders, even if it was true that they died earlier. You know, I haven't seen evidence that that they do. What else are they engaging in, like, engaging in sport like as a sumo wrestler athletes are putting their body putting a toll on their body with their with their sports, right? Right. And what are they doing to stay

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in shape to do the shoot sumo wrestling? What what is their, their genetic disposition? What is their what are their stress levels? What is like, like, what is a billion different things we can't tell and bodybuilders and and we all know a lot of bodybuilders and obviously this is my anecdotal evidence that I won't say a lot but we know bodybuilders who take steroids and, and die because of that. And, and as well, bodybuilders Holy fucking shit. The stuff that they do to make sure that their skin is really thin for shows. dehydrating themselves eating nothing, that diet then they eat hardly anything for long stretches of time, aka yo yo dieting and what do we know about yo dieting? Is that increases risk of death and ill health. And so these bodybuilders are they're so they're so big. That's why they're so big. That's what the you know, their body can't handle all that mass. Well, what else is going on? Even if that is true? What else is going on? And we can't just pick out you know, oh, I know. I know people die. You can't just pick out that out and be like, Okay, I know exactly what it was is because they were a big guy. It's because they're a big guy. We don't know what else is going on? You know? Just take a deep breath from that one. Alright, so are you also talk about The brother in law who has problems with his knees and joints so let's talk about fat people on our knees that people on our knees and so let's go and visit Regan Chastain. And Reagan has obviously all the time I'm in love with her. And she's so fucking nice as well, like on a personal level to where you can just own is just Oh, yeah.

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Okay, so here's here's a quote from a an excerpt from a, a post that Reagan wrote, five, six years ago, fat people on our knees. And so this is what regular saying about fat people in our knees. The subject came up recently when I was giving a talk to a group of soon to be personal trainers about working with fat people. One of the guys said he was worried about working with fat people because the other potential for knee injury. I asked who in the room had had a knee injury in the past? Almost everybody not surprising in a room full of jocks put the hand up, I asked who had been given an option for treatment of their knee injury other than weight loss? Almost everybody. I asked them to raise their hand if, if they had only me given weight loss as a treatment option. Nobody. I asked whose knee injuries had responded to treatment and gotten better. Almost everybody, just like the ideas of weight causing health issues. The discussion about fat and joint health is also much more complicated than many would have us believe. There have been a few times in my life at various ways when I've had knee pain. When I was less fat. Doctors looked at things like muscle imbalances and tightness gait.

And sure enough, they were the solvable problem. When I had new knee pain a few years ago, the only explanation offered to me was brought to me by doctors was that I needed to lose weight. Because I had the luxury because I had the luxury of knowing how they treat these issues with smaller people. I asked the doctor if people who weren't fat had knee problems. After some pushing, he admitted that they do. So I said that I wanted to be treat like treated like they treat thin people, I was told that there was no point in treating any other illness or any other issues until I lost weight. What were the who now. So I left the doctor's office and did some research, I started working with a massage therapist. And when we cleaned up the tightness in my quads, and IT bands, the knee pain disappeared, losing weight would have done nothing to help with the actual issue, in fact, continuing to work out so that I could get thin so that I could somehow quote unquote deserve evidence based healthcare would have been more likely to have exasperated exasperated the problem from one that we could could have been solved through a couple of good massages to one more serious issue that could have been blamed not on my doctor's incompetence, but wait for it on my way. So so someone wrote that post.

And then there was a comment. And so she made a there was lots of comments, but one of the comments stood out for her and she made another post. And the post is from 2020. And it says Does being fat cause arthritis? And does that even matter? So this is the comment that she's responding to. I agree that often the problems are tightness in the muscles. And that should always be addressed if it's an issue. But there is also a lot of research about the pure physics of having more force exerted on joints. This is me speaking. Don't take this person's common as this is fact. In case that wasn't obvious. So there's the pure physics of having more force exerted on joints and feet that cause more wear and tear and lead to more arthritis. Is that research wrong? Is there counter research been done? If you know of it, can you direct me to it? Thanks. So Reagan continue. That's not actually the most important question, but I'll answer it anyway, because it's so very misunderstood. To clarify for this discussion, when I talk about arthritis, I'll be talking about osteo arthritis, and it's way more complicated than just larger body equals greater risk. First, because so many factors are involved. Everything from access to support a footwear to participation in athletics at various ages, to the knowledge of coaches and trainers, if one does participate, etc.

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Research shows a correlation between larger bodies and greater risk, but that's far from showing causation before the cause could be attributed to bodies Sighs alone, there would hope there would have to be studies that control for the many variables that impact fat people to name just a few fat people's inability to get competent health care for joint pain, especially early joint pain. Instead, we are typically being prescribed weight loss, which causes additional issues, the effects of weight cycling a yo yo dieting on long term joint health, since most diets end in weight regain, and most of that poor fat people are put on multiple diets or less experienced weight cycling, the effect of exercising while purposefully giving your body less fuel than it needs, which is typically suggested to fat people as quote unquote weight loss innovation intervention on joint health, the effect of stigma, including the impact of stigma on fat people seeking out care at the same rate and level of injury slash slash pain that thin people do on fat people participating in physical activities that might mitigate their risk for arthritis.

These are just a few of the issues with research around weight and health. The truth is because of weight stigma, fat people experience the world differently than thing people do. And these differences impact our health, including our joint health. And all of that must be accounted for before we attribute health issues to fat bodies. Okay. So also, we said that your brother in law has diabetes, presuming it's type two. So I've mentioned this before, but there's a really incredible resource called Hayes health sheets.com Hayes H EY E S Health sheets.com. And it gives you the non fat phobic research behind common illnesses. So diabetes is mostly a genetic condition. Okay, you cannot eat your way into having diabetes.

Also, a lot of what you know outside being genetics, yo yo, dieting is a factor as well. So you know, oh, he's got diabetes. Oh, well, what a genetic condition. So, so an excerpt from here. What causes it? A number of factors can contribute to an increased risk of type two diabetes, including weight cycling, and internalized weight stigma, but type two diabetes. Diabetes is predominantly a genetic condition. While much fat phobic mission misinformation floats around, you cannot eat your way into type two diabetes, and it affects people of all sizes. And so we know that you're your brother in law, you know, is it is you know, he's not giving himself illness. Okay. So something that I saw on fat Doctor UK, which is a fat doctor, from the UK, no share Victoria. Fat doctor, the UK on Instagram, and I went to her website, trigger warning, fat doctor, she's open about her journey into previously being fat phobic and learning about this stuff. And now moving into being fat positive. And her more recent stuff is aligned with what we're talking about. But if you go on her website, and you look a few posts back, like a few, you know, blog posts, in the in recent, you know, in the last year or whatever, there is things in there that I'm like, oh, and so just a content warning there. But something that fat doctor, who is who is a general practitioner in the UK uses and doctors in the UK, US, too. Calculate your risk of stroke or heart attack.

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And so it's called the Q risk calculator is really, really fucking interesting. So the, the queue Risk Calculator will tell you, Okay, if you put in I'm going to I'm going to go to it right now. The first thing you do is you put in your age Okay? So, I am 36. So I'm going to put 36 you put your sex, there's no, it's only male or female, there is no option for anything else. Presuming if you are non binary, if you're trans, gender non kufr, non conforming, anything like that, then this will have an effect, but the data that they've got is just, you know, binary sex. Okay, so that is x female, and then ethnicity. So, white smoking status. I'm a nonsmoker. diabetes status, none. angina or heart attack, no. Chronic disease, kidney disease, no.

And then so it keeps going on different things like do you have migraines, rheumatoid arthritis, lupus. Different there's so there's maybe like 10 different things here. And then at the bottom, you put in your height and your weight. So I am 170 centimeters. I don't know what my weight is. But let's just put always in kilos. So say. So trigger warning here if you're, if you don't want to hear weights, so let's just put in 113 kilos, which is 250 pounds, so let's put that 113 kilos. Okay, let's do 115, why not round up. So I'm going to count. So I'm going to calculate my risk right now of stroke or heart attack. So anything and so I'm fat, if y, anything under 10% is considered low risk. So my risk right now or having a heart attack or stroke within the next 10 years, is again, under 10% is low risk. It is 0.6%. It says in other words, in a crowd of 100 100 people with the same risk factors are you naught point six are likely to have a heart attack or stroke within the next 10 years. Okay. So let's change that to say if I was straight size, so um, don't even know what that would be, let's say 150 pounds, versus 250 pounds. And that is 68 kilos, okay. And let's put that in 68 kilos. So what risk are what? How much is my risk going to change? Say if I lost 100 pounds? Okay, so, as we know, you know, me being sarcastic. As we know, if you lose weight, you're going to less likely to have a hard time because fat people are having heart attacks all over the shop. Okay, so my height is the same 170 centimeters, that's five foot seven, by the way, weight 68 kilos or 150 pounds. And by the way, 150 pounds in stone for our British people is just Googling this fish panels in stone is 10 stone. And 250 pounds in stone is 17.8. Stone. Okay, so.

So imagine if I magically became a thin person, not even if I became a thin person, because I've experienced stigma, I've done yo yo dieting, all that type of stuff. So imagine if there was just another version of Victoria running around who happened to be straight size. So my risk, my risk as a fat person of having a stroke or heart attack in the next year is in next 10 years is naught point six. If I were a thin person, it would be naught point four. And now that change that change, we don't know why that there is that and it's a tiny change like point 4% point 4%. And so the increased risk of point 2% It could be because of yo yo dieting because of stigma because of lack of access to health care because socio economic status like you know, there is no causation there in this thing. Okay. Let me give you a few more scenarios, because you might be like, Well, I'm, I'm 50 and I'm fat. And I have a condition. Okay, so let's say you are 50 You're female, and let's say you are

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black, African, okay. Let's say you're black, African, and let's say you're an ex smoker. Okay, so you are 50 female, black African ex smoker. Let's make your shorter let's make you 160 centimeters, and let's make your weight I don't know. 400 pounds, so 400 pounds in kilos, so 400 pounds in stone is 28 stone. So 400 pounds in kilos is 181. Okay, so 181 Let's just do 180 Because I think 180 is the highest. So height is 160, centimeters weight 180, you're 50, you're an ex smoker, and you're black African, and you're a woman, your risk of having a heart attack in the next 10 years. So again, reminder, anything under 10% is considered low risk. So if you're a 50, a female black African ex smoker, who weighs 400 pounds, your risk of having a heart attack, or stroke within the next 10 years, anything under 10% is low risk is 1.8%. Okay, so your if your 400 pounds, 400 pounds is 180 kilos is in stone, forgot what it was, is 28.5 stone. So that is on the higher end of the of the weight spec spectrum. And so if if you knew someone who was 400 pounds, for example, and you're fat phobic, you'd be like for they are a heart attack waiting to happen, you know, any day now, whether actually, their risk of having a heart attack is one or stroke is 1.8% In the next 10 years. You know, it just this. And so this is by the way, what this thing is, you know, this calculator, this is not just something that I'm pulling out of my ass. This is what doctors use. And it is a so I'm going to read from Wikipedia. key risk three is a prediction algorithm for cardio vascular disease that uses traditional risk factors age, blood pressure, smoking, blah, blah, blah, together with BMI, ethnicity, measure, measures of deprivation, family history, all this type of stuff. To calculate the prediction of cardiovascular disease, acute risk over 10% indicates that primary prevention with lipid lowering should be considered. So in the UK, the national issue for Health and Care Excellence NICE guidelines recommend using Q risk.

So because think about it, if we just went on BMI alone, if we just said okay, well, someone who is 400 pounds, and who is 180 160 centimeters, so what's that in foot 160 centimeters in feet is five foot two, okay? Traditional like BMI, you know, the doctor would like Oh my, you know you're about to die. But if we look at the things that actually make up health, when it's a different story, so let's make it okay. You're a 60 year old male. Let's make Indian. Let's say you are a heavy smoker. Okay, so a 60 year old male, Indian heavy smoker, diabetes, type two. On blood pressures, treatments, has rheumatoid arthritis arthritis. On steroid tablets, I'm just taking a few of these things and is 400 pounds and is five foot two. Okay, so a six year old Indian male who is a heavy smoker who has type two diabetes on blood pressure treatment, rheumatoid arthritis on regular steroid tablets, so let's calculate the risk here. Let's have a look.

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So the risk here is 58.4%. Alright, that's where these other things you know, heavy smoker, did it. So let's take away the only thing we have here is so this is a six year old Indian male risk of having a heart attack and stroke in the next 10 years is 58%. Let's go To let's let's take everything out apart from weight. So if you're just a six year old Indian guy who is 400 pounds, okay, let's have a look. So taken away the fact that you let you know, let's stop smoking, taken away all of that other stuff and just being 60, male Indian 400 pounds, five foot two risk of having a heart attack or stroke in the next 10 years 12.6%. Okay, so anything under 10 is low risk. So this is slightly over low risk. But if you saw a six year old guy who was 400 pounds, you'd be like, ah, any day now, any day. But actually, it's not about the body size, it's about other complicated things. We just can't, we just can't go around saying fat people are gonna die. We don't have the information. It's so complicated. Like, I'll link to all of these. And so if you want to see your actual, your risks and all that type of stuff, then I'll link to the que Risk Calculator.

And so if you're like, Oh my God, I feel like I'm about to die, you can have a look at this and see if that is based in reality, or if it's based in that area, and just catering continuing on about what that calculator is. The algorithm has subsequently been validated by an independent team for the center of statistics in medicine, University, Oxford, using external data sets. And it says it performs better than other things in in, in predictions. It's updated annually to reflect changes in populations. Yeah, so this is the gold standard. And this is what the UK uses. And obviously not saying the UK is the best in the world. Because we know that UK is fat phobic. But that's that's that's that. That's that. And that is something that, that I discovered from the fact Dr. UK. Finally, on this topic, finally, I want to talk about the determinants of health. So I'm going to link up to this beautiful pie chart, illustration thingamajig.

Basically, there is this really awesome thing, study into what makes up quote unquote, health. So let me go and tell you. So, so basically, this this information is taken from a ton of reputable sources, lots of different sources, with lots of different studies that show up like show what makes up health, okay, and so there's tons and tons of information, and they've put that into this really detailed illustration. Okay. And so, the determinants of health, individual behavior, determinants of health, okay, so what we have been told is, what food you eat and how much you exercise is going to determine whether you live or die. And it's obviously an individual thing, and you might be unlucky and you know, get cancer, but that's not your fault. Unless you're fat, then it probably is. So, individual behavior makes up 36% of the determinants of health. That means other stuff 64% make up

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the time determinants of health at a population level, okay? So individual behavior what that means exactly, so individual behavior, like okay, well, do I eat, quote unquote, healthy, that's probably what that means. Do I exercise, okay. individual behavior, smoking habits, sleep and exercise patterns, sexual activity, and mood levels are all examples of individual behavior. This is me quoting from them, which is a critical determinant for our physical health, mental health and overall well being. positive changes to our individual behavior can reduce the risk for developing a variety of diseases, and many health intervene interventions are focused on altering dangerous behavior. And so broken up broken up into this individual behavior is first. Not first, but I'm what I'm saying is first, what I'm saying first. So, psychological assets. So, this is individual behavior of what makes up health 36%. And inside that 36% is psychological assets. So that is conscientiousness level, self efficacy, optimism level, life, life satisfaction level, cognitive function in late life, negative mood and effects. So, negative mood and effects is another one. And that includes stress level, hopelessness level, anxiety level, and depression level.

Next, another category is other risk related behavior, gun behavior, sexual activity motile motor vehicle behavior. Next we have physical activity, sleep patterns, diet patterns, huh? Oh, well, well, well, wait, is not in there as a individual behavior, because weight is not a behavior. And notice, like, you know, diet patterns, and physical activity is one of 1234 subcategories. And those and it's not even a subcategory with, as you know, 12345666 subcategories. It's not even one with with information underneath it. So, you know, we don't say, Oh, you're so unhealthy, because you like to go to the shooting range, you're so unhealthy, you should stop being a burden on society, because you drive a car, you should stop being such a piece of shit because you like having sex with people. You're, you're you're causing your early death, because you gave a guy a blowy. We don't say her, you know, we don't say that, you know, will shame people, but we will. We're not like, you know, you're gonna die early. Because, you know, we all know that everyone who has sex. We all know everyone who has sex is so unhealthy. Oh, you know? But it's, it's sort of the same like because, you know, gun behavior, having a gun is risky, you know, sexual activity, if you're having unprotected sex, and listen, you know, there's no such thing as safe sex, really. It can be risky, having a car, fuckin risky. But we, you know, we have all of this, this is just the individual behavior. So this is just 36% of what makes up health. Okay, and then in all of that stuff, we have one line that says diet patterns and physical activities.

And we ignore everything else like sleep stress, and the fact that weight is not a behavior. We ignore that too. We're like, well, just that then, then you'll be really healthy. No, the other one is, in case you're interested, the other determinants of health. 64% is social determinants. And so social determinants is gender identity, military service, sexual orientation, citizens ship status, race and ethnicity, social status, history of incarceration, culture and tradition, social connectedness, early childhood education and development, discrimination and work conditions. And so that is 24% 22% is genetics and biology. So under that we have genetics. That means we're just talking about like chromosomes.

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Yeah, so chromosomes and Gene, so literally genetics. And then under genetics, we've got gender. And then we have also body structure. And so body structure we've got age, and then underneath that, so it's like a layer deeper, we have height, weight, waist to hip ratio, so that's not even on the that's like the getting into the really nitty gritty. So, so genetics, and biology, so we've got genetic body structure, and we have body function. So body function, bone density, nutritional status, biomedical function, century function, movement and balance, strength and robustness. So that's 22%. Next, medical care. Medical care is 11%. So this is Social Determinants of Health 11% is medical care. So medical care underneath that we have health literacy, quality of health care, access to health care, and patient engagement. Okay, and so that's, that's 11%. Right? So think about it. So we have here quality of healthcare as a fat person, you're not getting quality of health care, a lot of times access to health care, you're not getting the access. And if you live in a country like the US, then you know, it's about how much money you have to access health care. Patient Engagement, well, a lot of fat people go to the doctor and get fat shamed, and don't go back again. Right. So next 7% is physical environment. This is the last one. So physical environment this is location, exposure to firearms, allergens and pollution.

So, well, well, well, when we're talking about fat people are so unhealthy or we like you're so unhealthy, you should really reduce your exposure to firearms, you're so unhealthy, you should really cut down on the amount of pollution you're exposed to. No, we say found people you're so unhealthy, you should really change your body size, which is one point in a fork of many, many forks. And it's not a an individual behavior. It is a genetic and biology thing. So fat people, you're so unhealthy, you should change your genetics. How about like, if you want to be healthy, there's lots of different ways to go about it. And it's none of our business

1:01:49

Oh, that's what I think about it. Like and it's not, you know, so unhealthy. So unhealthy. And so I'm going to increase their stigma and, and fatphobia and so that they feel like at least we share it and so that they do things that damage their house, because I think that that I think that that's what sadly this is a trouble speaking by the way. One other one actually another one I forgot to mention an individual behavior drug use. So that is alcohol, tobacco and other substances. So we've got psychological assets and this is individual behavior, psychological assets, negative mood, and effects drug use sleep and diet pattern, physical activity, other risk related behavioral ORs. Yeah, so it's just so interesting, isn't it? Because you know, when I say, oh, you should really stop driving a car if you want to be healthy. It's just silly, right? Because, you know, we just don't say that. Like, sometimes you might be like, Oh, it's it is actually, you know, dangerous to drive a car. But we're not then blaming people, like say, if someone got into a car accident, you're not going to be like, Well, you had it come in you were driving to and from work every day. So who are you going to blame? Yeah, you might have got rear ended. But still, you know, if you weren't engaging in unhealthy behavior, like driving a car, then you wouldn't be now in hospital, you bastard. But that's not how we treat our people. Don't make sense. Sow, sow, sow, sow, sow, sow, sow, sow, sow. So so many links in this. In this episode, I'm going to make sure they are all in the show notes for your show notes again, facebook.com, forward slash 080 for episode 80. And you're going to get all those links. So in response, let's make sure I've covered everything on this. I am new to the face fatty community and have been trying to explain things to my husband. He is on board, but he has some hang ups. He is very science minded and research oriented. Okay, so we've given you the research, which is great. I love it when people are very science minded because I'm like, Fuck, yeah, if you're into science, and you'll see the science and you're like, Oh, shit. I was wondering if you can point me in the direction of any resources explaining how fat does not equal unhealthy.

So we've got these resources here in this and this is just you know, this is not an extensive list of resources. In in my program, first of all Academy I have a spreadsheet where I keep like all the fat positive books, Ted Talks, studies shows anything fat related that we want to get into our head into our head and in the section where we've got studies and studies and articles and things like that. We're up to like 100 70 Not all of related to this, specifically, but that there are a lot more. And that is just the stuff that I've uncovered in the last few years. And this is not even, you know, everything that's out there. So he's got a brother who's in a larger body and has knee and ankle problems. So knee and ankle problems, as we know, happens to everyone at every size. And we can improve that by doing the same things that straight size people do. And his diabetic, diabetic genetic condition, which my husband attributes to his weight, because husband attributes to his weight. But as we know, correlation is not causation. When I point out that he's not very active, and so he's not very active. And as we know, from the first two studies that I shared, if someone is active, any increased risk because of body size is practically wiped out. He says that bodybuilders and sumo wrestlers don't live long because their hearts aren't made to support that much mass.

1:06:13

As we can tell, that is anecdotal evidence. We also don't know we don't know if that's actually true. And even if it were true, do we have evidence to show to strip away everything else that could be going on in their life, the fact that they are athlete, which is risky, the fact that they could be using performance enhancing drugs, which could be risky, the pack the fact that they're a performer, and have have increased stress in their life, which could be risky? The the fact that they're on the road on the road, and they maybe don't get enough sleep, which could be risky. If we strip away all of that stuff. Do we have evidence to show that sumo wrestlers die at a younger age? Because they have fat bodies? No, no, we do not. I don't know how to respond to this. And truthfully, I wonder, is there any truth in this, or hopefully this episode has showed you that it's, it's a complicated issue. And looking at it in this binary way is not helpful. So if you're feeling things from this episode, because of my, you know, me using the the Oh words, and me going into that calculator to look at sizes and mentioning sizes, please take care of yourself right now. And as well, if you are not engaging in these, quote unquote, Health, promoting behaviors, and you're feeling away about it, then, you know, try not to, like, if you want to improve your health, then we know ways that we can do that.

And as we know, individual behavior only makes up 36%. Of, of health, determinants of health. You know, recognize that we have some control, but we don't have that much. And you don't owe health to anyone. And your health status is no one's business but your own. You know, so if you're getting any type of way of like, oh, no, I am a smoker and oh, no, I, I don't move my body or whatever. Like, you know, just give yourself some compassion. Okay. You have to find some compassion. Because it's a Yeah, being especially nowadays when when we have the pandemic, the panorama, the pizza, the Papa, Puppy, this global panorama that we're in it just, you know, something that's just really reinforced for me is just to have compassion for yourself, really have compassion for yourself because we're all trying to survive and. And in that's difficult for a lot of people. So thank you for hanging out with me today and helping me with my anxiety. I appreciate it. And let me know if you liked this episode. And if you have any questions, then you can go to the show notes where there is a form that you can fill in. Especially if you want to ask an anonymous question. You can just put that in there. And if it's a good one, I will answer it on the show. Okay, We'll see later ah Am I seeing my son I'll see you later crocodile and you stay fears fatty

1:10:19

thanks for listening to the episode and if you feel ready to get serious about this work and want to know when the doors open to fears fattier Academy which is my signature program where I teach all about how to overcome your fat phobic believes and learn to love your fat body, then go to first fatty.com forward slash waitlist again that is phase fatty.com. Forward slash waitlist to get your name on the waitlist. For when first fatty Academy my signature program opens