Fat’s Real Barriers To Health
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Fat Justice In Healthcare
This is Aubrey Gordon, an author, podcaster, and fat justice activist. What does that mean?
When it comes to healthcare, we previously covered some ideas very similar to her work, such as how…
There’s a lot of discrimination in healthcare settings
In this case, it often happens that a thin person goes in with a medical problem and gets treated for that, while a fat person can go in with the same medical problem and be told “you should try losing some weight”.
Top tip if this happens to you… Ask: “what would you advise/prescribe to a thin person with my same symptoms?”
Other things may be more systemic, for example:
When a thin person goes to get their blood pressure taken, and that goes smoothly, while a fat person goes to get their blood pressure taken, and there’s not a blood pressure cuff to fit them, is the problem the size of the person or the size of the cuff? It all depends on perspective, in a world built around thin people.
That’s a trivial-seeming example, but the same principle has far-reaching (and harmful) implications in healthcare in general, e.g:
- Surgeons being untrained (and/or unwilling) to operate on fat people
- Getting a one-size-fits-all dose that was calculated using average weight, and now doesn’t work
- MRI machines are famously claustrophobia-inducing for thin people; now try not fitting in it in the first place
…and so forth. So oftentimes, obesity will be correlated with a poor healthcare outcome, where the problem is not actually the obesity itself, but rather the system having been set up with thin people in mind.
It would be like saying “Having O- blood type results in higher risks when receiving blood transfusions”, while omitting to add “…because we didn’t stock O- blood”.
Read more on this topic: Shedding Some Obesity Myths
Does she have practical advice about this?
If she could have you understand one thing, it would be:
You deserve better.
Or if you are not fat: your fat friends deserve better.
How this becomes useful is: do not accept being treated as the problem!
Demand better!
If you meekly accept that you “just need to lose weight” and that thus you are the problem, you take away any responsibility from your healthcare provider(s) to actually do their jobs and provide healthcare.
See also Gordon’s book, which we’ve not reviewed yet but probably will one of these days:
“You Just Need to Lose Weight”: And 19 Other Myths About Fat People – by Aubrey Gordon
Are you saying fat people don’t need to lose weight?
That’s a little like asking “would you say office workers don’t need to exercise more?”; there are implicit assumptions built into the question that are going unaddressed.
Rather: some people might benefit healthwise from losing weight, some might not.
In fact, over the age of 65, being what is nominally considered “overweight” reduces all-cause mortality risk.
For details of that and more, see: When BMI Doesn’t Measure Up
But what if I do want/need to lose weight?
Gordon’s not interested in helping with that, but we at 10almonds are, so…
Check out: Lose Weight, But Healthily
Where can I find more from Aubrey Gordon?
You might enjoy her blog:
Aubrey Gordon | Your Fat Friend
Or her other book, which we reviewed previously:
What We Don’t Talk About When We Talk About Fat – by Aubrey Gordon
Enjoy!
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Most People Who Start GLP-1 RAs Quit Them Within A Year (Here’s Why)
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Specifically, 54% quit within one year, with that number rising to 72% within two years.
We first wrote about GLP-1 receptor agonists (i.e. semaglutide drugs like Ozempic and Wegovy) a couple of years ago when popularity was just beginning to take off:
However, as we had room only to touch briefly on the side effects and what happens when you stop taking it, you might also want to check out:
What happens when I stop taking a drug like Ozempic or Mounjaro?
…and:
Notwithstanding all this information, there’s a lot of science that has still yet to be done. If you’re a regular 10almonds reader, you’ll be familiar with our research review articles—this one was more of a non-research review, i.e. looking at the great absence of evidence in certain areas, and the many cases of research simply not asking the right questions, for example:
❝Of the four studies that actually looked at the macros (unlike most studies), they found that on average, protein intake decreased by 17.1%. Which is a big deal!
It’s an especially big deal, because while protein’s obviously important for everyone, it’s especially important for anyone trying to lose weight, because muscle mass is a major factor in metabolic base rate—which in turn is much important for fat loss/maintenance than exercise, when it comes to how many calories we burn by simply existing.
A reasonable hypothesis, therefore, is that one of the numerous reasons people who quit GLP-1 agonists immediately put fat back on, is because they probably lost muscle mass in amongst their weight loss, meaning that their metabolic base rate will have decreased, meaning that they end up more disposed to put on fat than before.❞
Read in full: Semaglutide’s Surprisingly Unexamined Effects ← there are a lot more (equally concerning) items discussed in this article
Why people quit GLP-1 RAs
There was a large (n=125,474) study of US adults. The average age was about 54 years, and about 65% were female.
From the total data pool (i.e. not narrowing it down by demographic), 54% stopped within a year, and 72% within two years.
The factors most associated with discontinuation were:
- age above 65 years
- not having type 2 diabetes
The main reasons given for discontinuation were:
- High costs: self-explanatory, but it’s worth noting that people who stopped for this reason were more likely to restart later.
- Adverse side effects: the most common ones were nausea, vomiting, diarrhea, constipation, stomach pain, and loss of appetite. Rarer, but more seriously, side effects included: pancreatitis (severe abdominal pain, nausea, vomiting), gallbladder issues (gallstones, cholecystitis), kidney problems, severe allergic reactions (rash, swelling, difficulty breathing), hypoglycemia, especially if taken with insulin or other diabetes medications, changes in vision (worsening diabetic retinopathy), and an increased heart rate.
- Disappointingly little weight loss: the researchers noted that GLP-1 RA results are “heterogenous”, meaning, they differ a lot. For those for whom it didn’t work, quitting was more likely, for obvious reasons. See also: 10 Mistakes To Sabotage Your Ozempic Progress
- Successful weight loss: while it is widely known that if one stops taking GLP-1 RAs, weight regain is the usual next thing to happen, there are a lot of people who go onto GLP-1 RAs with the rationale “I’ll just use this to lose the weight, and then I’ll keep the weight off with my diet and lifestyle”. Which sounds reasonable, but because of the specific mechanisms of actions of GLP-1 RAs, it simply doesn’t work that way (and, as we mentioned above, there are reasons that you may, after stopping taking GLP-1 RAs, be more disposed to put weight on than you were before you started). So, by the best of current science (which admittedly is not amazing when it comes to this topic), it does seem that taking GLP-1 RAs is a lifetime commitment.
You can read the study itself here:
Want to get similar results, without GLP-1 RAs?
Then check out:
5 Ways To Naturally Boost The “Ozempic Effect” ← this is about natural ways of doing similar hormone-hacking to what GLP-1 RAs do
and
Ozempic vs Five Natural Supplements ← this is about metabolism-tweaking supplements
and
Hack Your Hunger ← this is about appetite management
Take care!
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Nutritional Profiles to Recipes
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝I like the recipes. Most don’t seem to include nutritional profile. would lilke to see that. Macro/micro world…. Thank you❞
We’re glad you’re enjoying them! There are a couple of reasons why we don’t, but the reasons can be aggregated into one (admittedly rare) concept: honesty
To even try to give you these figures, we’d first need to use the metric system (or at least, a strictly mass-based system) which would likely not go well with our largely American readership, because “half a bulb of garlic, or more if you like”, and “1 cucumber” or “1 cup chopped carrot” could easily way half or twice as much, depending on the sizes of the vegetables or the chopping involved, and in the case of chopped vegetables measured by the cup, even the shape of the cup (because of geometry and the spaces left; it’s like Tetris in there). We can say “4 cups low-sodium broth” but we can’t say how much sodium is in your broth. And so on.
And that’s without getting into the flexibility we offer with substitutions, often at a rate of several per recipe.
We’d also need to strictly regulate your portion sizes for you, because we (with few exceptions, such as when they are a given number of burger patties, or a dessert-in-a-glass, etc) give you a recipe for a meal and leave it to you how you divide it and whether there’s leftovers.
Same goes for things like “Extra virgin olive oil for frying”; a recipe could say to use “2 tbsp” but let’s face it, you’re going to use what you need to use, and that’s going to change based on the size of your pan, how quickly it’s absorbed into the specific ingredients that you got, which will change depending on how fresh they are, and things like that.
By the time we’ve factored in your different kitchen equipment, how big your vegetables are, the many factors effecting how much oil you need, substitutions per recipe per making something dairy-free, or gluten-free, or nut-free, etc, how big your portion size is (we all know that “serves 4” is meaningless in reality)… Even an estimated average would be wildly misleading.
So, in a sea of recipes saying “500 kcal per serving” from the same authors who say you can caramelize onions in 4–5 minutes “or until caramelized” and then use the 4–5 minutes figure for calculating the overall recipe time… We prefer to stay honest.
PS: for any wondering, caramelizing onions takes closer to 45 minutes than 4–5 minutes, and again will depend on many factors, including the onions, how finely you chopped them, the size and surface of your pan, the fat you’re using, whether you add sugar, what kind, how much you stir them, the mood of your hob,
and the phase of the moon. Under very favorable circumstances, it could conceivably be rushed in 20 minutes or so, but it could also take 60. Slow-cooking them (i.e. in a crock pot) over 3–4 hours is a surprisingly viable “cheat” option, by the way. It’ll take longer, obviously, but provided you plan in advance, they’ll be ready when you need them, and perfectly done (the same claim cannot be made if you budgeted 4–5 minutes because you trusted a wicked and deceitful author who wants to poop your party).Take care!
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Military Secrets (Ssh!)
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Can you keep a secret?
When actor Christopher Lee was asked about his time as a British special forces operative, he would look furtively around, and ask “can you keep a secret?” Upon getting a yes, he would reply:
“So can I”
We can’t, though! We just can’t help sharing cool, useful information that changes people’s lives. Never is that more critical than now, as the end of January has been called the most depressing time of year, according to Dr. Cliff Arnall at the University of Cardiff. It doesn’t have to be all doom and gloom, though:
Today we’re going to share a trick… It’s called the “secret of eternal happiness” (yes, we know… we didn’t come up with the name!) and is taught to soldiers to fend off the worst kinds of despair.
The soldiers would be ordered to take a moment to reflect on the sheer helplessness of their situation, the ridiculous impossibility of the odds against them, all and any physical pain they might suffer, the weakness of their faltering body… and just when everything feels as bad is it can possibly feel, they’re told to say out loud—as sadly as possible—this single word:
“Boop”
It all but guarantees to result in cracking a smile, no matter the situation.
Now this knowledge is yours too! Keep it secret! Or don’t. Sharing is caring.
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The Menopause Brain – by Dr. Lisa Mosconi
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With her PhD in neuroscience and nuclear medicine (a branch of radiology, used for certain types of brain scans, amongst other purposes), whereas many authors will mention “brain fog” as a symptom of menopause, Dr. Mosconi can (and will) point to a shadowy patch on a brain scan and say “that’s the brain fog, there”.
And so on for many other symptoms of menopause that are commonly dismissed as “all in your head”, notwithstanding that “in your head” is the worst place for a problem to be. You keep almost your entire self in there!
Dr. Mosconi covers how hormones influence not just our moods in a superficial way, but also change the structure of our brain over time.
Importantly, she also gives an outline of how to stay on the ball; what things to watch out for when your doctor probably won’t, and what things to ask for when your doctor probably won’t suggest them.
Bottom line: if menopause is a thing in your life (or honestly, even if it isn’t but you are running on estrogen rather than testosterone), then this is a book for you.
Click here to check out The Menopause Brain, and look after yours!
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Figs vs Passion Fruit – Which is Healthier?
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Our Verdict
When comparing figs to passion fruit, we picked the passion fruit.
Why?
Both are top-tier fruits! But the passion fruit is just that bit more passionate about delivering healthy nutrients:
In terms of macros, passion fruit has slightly more carbs, notably more protein, and a lot more fiber, giving it the win in this category.
In the category of vitamins, figs have more of vitamins B1, B5, B6, E, and K, while passion fruit has more of vitamins A, B2, B3, B9, C, and choline, making for a marginal win by the numbers for passion fruit here.
When it comes to minerals, figs have more calcium, manganese, and zinc, while passion fruit has more copper, iron, magnesium, phosphorus, potassium, and selenium. A clearer win for passion fruit this time.
Adding up the sections makes for an easy overall win for passion fruit, but again, figs are really a top-tier fruit too; passion fruit just beats them! By all means enjoy either or both; diversity is good!
Want to learn more?
You might like:
Top 8 Fruits That Prevent & Kill Cancer ← figs have antitumor effects specifically, while removing carcinogens too, and additionally sensitizing cancer cells to light therapy
Enjoy!
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Toothpastes & Mouthwashes: Which Help And Which Harm?
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Toothpastes and mouthwashes: which kinds help, and which kinds harm?
You almost certainly brush your teeth. You might use mouthwash. A lot of people floss for three weeks at a time, often in January.
There are a lot of options for oral hygiene; variations of the above, and many alternatives too. This is a big topic, so rather than try to squeeze it all in one, this will be a several-part series.
For today, let’s look at toothpastes and mouthwashes, to start!
Toothpaste options
Toothpastes may contain one, some, or all of the following, so here are some notes on those:
Fluoride
Most toothpastes contain fluoride; this is generally recognized as safe though is not without its controversies. The fluoride content is the reason it’s recommended not to swallow toothpaste, though.
The fluoride in toothpaste can cause some small problems if overused; if you see unusually white patches on your teeth (your teeth are supposed to be ivory-colored, not truly white), that is probably a case of localized overcalcification because of the fluoride, and yes, you can have too much of a good thing.
Overall, the benefits are considered to far outweigh the risks, though.
Baking soda
Whether by itself or as part of a toothpaste, baking soda is a safe and effective choice, not just for cosmetic purposes, but for boosting genuine oral hygiene too:
- Enhanced plaque removal to improve gingival health: 3-month randomized clinical study of the effects of baking soda toothpaste on plaque and gingivitis
- The effects of two baking-soda toothpastes in enhancing mechanical plaque removal and improving gingival health: A 6-month randomized clinical study
- The efficacy of baking soda dentifrice in controlling plaque and gingivitis: A systematic review
Activated charcoal
Activated charcoal is great at removing many chemicals from things it touches. That includes the kind you might see on your teeth in the form of stains.
A topical aside on safety: activated charcoal is a common ingredient in a lot of black-colored Halloween-themed foods and drinks around this time of year. Beware, if you ingest these, there’s a good chance of it also cleaning out any meds you are taking. Ask your pharmacist about your own personal meds, but meds that (ingested) activated charcoal will usually remove include:
- Oral HRT / contraceptives
- Antidepressants (many kinds)
- Heart medications (at least several major kinds)
Toothpaste, assuming you are spitting-not-swallowing, won’t remove your medications though. Nor, in case you were worrying, will it strip tooth enamel, even if you have extant tooth enamel erosion:
Source: Activated charcoal toothpastes do not increase erosive tooth wear
However, it’s of no special extra help when it comes to oral hygiene itself, just removing stains.
So, if you’d like to use it for cosmetic reasons, go right ahead. If not, no need.
Hydrogen peroxide
This is generally not a good idea, speaking for the health. For whitening, yes, it works. But for health, not so much:
To be clear, when they say “alter”, they mean “in a bad way”. It increases inflammation and tissue damage.
If buying commercially-available whitening toothpaste made with hydrogen peroxide, the academic answer is that it’s a lottery, because brands’ proprietorial compounding processes vary widely and constantly with little oversight and even less transparency:
Is whitening toothpaste safe for dental health?: RDA-PE method
Mouthwash options
In the case of fluoride and hydrogen peroxide, the same advice (for and against) goes as per toothpaste.
Alcohol
There has been some concern about the potential carcinogenic effect of alcohol-based mouthwashes. According to the best current science, this one’s not an easy yes-or-no, but rather:
- If there are no other cancer risk factors, it does not seem to increase cancer risk
- If there are other cancer risk factors, it does make the risk worse
Read more:
- Does the use of alcohol mouthwash increase the risk of developing oral cancer?
- Alcohol-based mouthwash as a risk factor of oral cancer: A systematic review
Non-Alcohol
Non-alcoholic mouthwashes are not without their concerns either. In this case, the potential problem is changing the oral microbiome (we are supposed to have one!), and specifically, that the spread of what it kills and what it doesn’t may result in an imbalance that causes a lowering of the pH of the mouth.
Put differently: it makes your saliva more acidic.
Needless to say, that can cause its own problems for teeth. The research on this is still emerging, with regard to whether the benefits outweigh the problems, but the fact that it has this effect seems to be a consensus. Here’s an example paper; there are others:
Effects of Chlorhexidine mouthwash on the oral microbiome
Flossing, scraping, and alternatives
These are important (and varied, and interesting) enough to merit their own main feature, rather than squeezing them in at the end.
So, watch this space for a main feature on these soon!
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