Yesterday’s whirlwind of activity spawned by the BBC story on our efforts to bring down the billboards in Georgia has brought an incredible diversity of opinions on the issue of weight and health to our comments, and I totally welcome that. I believe the only way to discover the truth is to unleash a cacophony of opinions, and gradually tease out the tone deaf arguments and baseless assumptions until we are left with a harmony of relative consensus.

What I have seen is that regardless of what you believe the reasons for obesity to be, the majority of people are in agreement that stigmatizing children is not the way to address the root causes. Earlier, I wrote about how in times like these, when the welfare of children is threatened by well-meaning ignorance, that I will take any ally I can in the fight. These unnatural allies may not be ideal, but when our mission is simple and our goal is singular, then it is time to set aside our differences, if temporarily, to achieve the desired outcome.

In this case, we are fighting to bring down the billboards in Georgia and to ensure that this “awareness” strategy will never be used against children again.

One way we are responding to the Strong4Life billboards is by raising money to erect a billboard of our own; one that celebrates the diversity of bodies and the joy of being fit and active. As Ragen says, it’s pretty difficult to hate yourself healthy.

On February 2, we launched our Big, Fat Moneybomb and raised over $12,000 in 24 hours for our billboard. Since then, we’ve raised a total of $15,500 on our main fundraising site, while we have raised an untold number of Solidarity Dollars through our PayPal account (since GoFundMe does not accept donations of less than $5).

On top of this, we still have the $5,000 More of Me to Love Match, which has two criteria: raise $5,000 (done!) and reach 1,000 donors.

Well, ladies and gentlemen, as of last night we are 56 donors away from our goal, and I know that we can finish our fundraiser today. So if you want to help us unlock an additional $5,000 in funding for our billboard campaign, please either donate a Solidarity Dollar (just one dollar, that’s all we ask), or if you wish to give more, there’s our main donation page. Either way, please help us make today the last day of our fundraising.

Now, onto to mish-mash…Yesterday, in an unprecedented move, the National Institutes of Health, the leading American authority on contemporary medical research, issued a, shall we say, hearty rebuke of Strong4Life’s shame campaign.

With that letter, Strong4Life has lost much of their rationale for ignoring the outcry of those who have been telling them that this campaign is doing more harm than good. Previously, Strong4Life has responded by citing their “market research,” which shows that their ads aren’t harming kids. As in this comment thread, they have said:

We have seen no evidence that these ads are harming kids. Among other indicators of success, our doctors tell us they are having better conversations in their offices with families… While the message in the ads may seem harsh, this method has proven successful in other public awareness campaigns, such as the Meth Project and anti-tobacco (Truth) campaign. We would never want kids to feel badly about themselves, but we are more heartbroken about the potential health consequences facing overweight or obese children and that is what we concentrate on in this community.

The ads are subjective, and the opinions of the critics of our approach so far are just that — opinions. We will not invest in lengthy arguments about it, nor will we entertain your idea that one can be healthy and overweight or obese. Medically speaking, it’s not true.

The “evidence” they are citing is the market research they say they have been conducting to monitor the psychological effects of the ads. Yet they have not released this market research to the public, or the research that underpins their claim that 3/4 of Georgians aren’t aware of the crisis (tomorrow will be ONE MONTH since they said they were “collecting bkgrd” on the research that they have used throughout this campaign).

So, essentially, we are told to trust them, that there is no proof that stigmatization harms and that they are monitoring the community for psychological damage.

This has been their stance all along, but until now it has been their response to a collection of healthcare professionals, bloggers and activists who have been speaking out. The NIH, on the other hand, is a totally different ball game. The NIH is the epicenter of medical research and they are aware of what the literature says about the effects of stigma and shame, as Dr. Guttmacher pointed out in his letter (PDF).

Surely Strong4Life can’t continue to ignore the evidence that their approach is harmful, right? They have to give the opinions of the NIH greater weight than that of the general rabble, right?

If that seems pretty common sensical to you, then you’re be sorely mistaken. From their Facebook response to the NIH:

We appreciate everyone’s perspective on this crisis – especially the NIH – because it is going to take incredible momentum to solve this crisis – much more than a short series of ads. In Georgia we know there is a disconnect between the reality of our childhood obesity crisis and the personal acknowledgment of the associated health risks. The discomfort people have with these ads is further evidence of this. http://www.bbc.co.uk/news/mobile/world-us-canada-16958865

While our critics presume to know the effects our ads will have on families and kids in Georgia, our physicians see the true effects of childhood obesity in our clinics every single day. The reality is that nearly 40 percent of kids ages 10-17 in Georgia are overweight or obese and have an increased chance of suffering from serious illnesses like fatty liver disease and type 2 diabetes. [emphasis mine]

These ads are accomplishing their objective: raising the dialogue on childhood obesity. But Strong4Life is much more than just an ad campaign; it is a movement that involves the entire community, delivering programs and creating partnerships. We needed the ads to spark the conversation around this issue. Awareness and intent to change are only the first steps in the fight against childhood obesity. People have to take personal responsibility.

Allow me to translate the carefully crafted PR-speak using the Babel Fish PR to English function:

Oh those rapscallions at the NIH… they think they know so much, what with their reams and reams of data on the negative psychological and physical consequences of obesity, but they are oblivious to the dangers of obesity! Our doctors know the true story, that unless we bludgeon children and parents with a perpetual assault of Vague Future Health Threats and fat jokes, then we the future will be lost. The ONLY way to save the children is through humiliation and shame, so trust us. We know what we’re doing.

Except this isn’t the only option. There are successful programs that encourage healthy eating and exercise for children of all sizes throughout the country. None of resorted to these kinds of extreme tactics, so what makes Strong4Life so special that they can ignore the growing coalition of voices telling them that shaming fat kids is a terrible idea?

And keep in mind, this “awareness” campaign has been going on for NINE MONTHS. If parents aren’t aware of this subject by now, what are the odds that continuing it will increase awareness?

I believe the answer lies in their gelatinous definition of “abuse.” For them, abusive language and abusive behavior is acceptable in the pursuit of a greater good. The risk of driving young people to unhealthy eating practices, if not outright eating disorders, is acceptable if it reduces the level of obesity in Georgia.

Likewise, the oversight on Strong4Life’s Facebook page gives us a glimpse into this questionable rationale. On January 11, early in our campaign against S4L, I was booted from their Facebook page, which I documented with screen caps of my offending comments. At the time, S4L posted the following comment on their FB page which explained why I was banned:

Okay, so “no swearing, threats, harassment, vulgarity or anything else that debases the purpose of this community or our staff.” You can judge for yourself whether I violated those rules.

Later, I went back using my friends and family FB account and have been responding to their medical claims with research and data (all of which they will not accept because fat is ALWAYS bad, regardless of what the research says). Of course, there are defenders of Strong4Life there as well. Most are relatively respectful (if woefully misinformed) in their disagreements, but the other day I received a comment that was beyond the pale. I’m just posting the most offensive parts of the comment, but you can read the full comment  within this thread

Judge for yourself whether this comment violates the guidelines used to justify my expulsion:

I’m going to be brutally blunt: SHUT UP! I, like many other here are sick & tired of listening to your crap about how ‘BULLYING’ is the cause of obese children! Get over it! Studies & numbers from statistic can be altered/doctored in any way to benefit those who want to make a point. The facts are this though: Fat/Obese children are for the most part, medical conditions aside, the product of today’s society in which a seditary lifestyle coupled with junk food has resulted in this epidemic. You don’t want to believe the facts, fine, go back to your couch, open up a box of Hosten Twinkies & wash ‘em down with a 2L bottle of soda! You know what … how do you both know what this advertising campaign will do to the kids? Kids follow examples set by their parents! I said it before, I’ll say it again, drop the kids from the bill boards & put up parents .. change the campaign around: ‘Kids, is this what you Really want to Look Like in 10 – 15 years?’ … now if you two along with your friends would get off the couch (as Wendy says) & start exercising .. 10 – 15 min. to start … slowly work it up to 30/45 minutes a day .. eat healthy food .. it’s a major serious lifestyle change, I can guarantee you will love youself for it & your body & organs, well, they will rejoice.

That’s just a small, rancid sample of how some of Strong4Life’s supporters have been responding to us in recent days. So, I asked S4L if they would adhere to their standards and remove the disrespectful, condescending, vulgar comment. Their response?

We walk a fine line managing conversation about such a sensitive topic, which is why we wrote rules of engagement and check it regularly to make sure it’s not overly vague or punitory. Shannon, you were banned early on as Atchka Fatty because you posted the names and numbers of our staff and encouraged a good deal of hate calls – that’s harassment and a very clear violation of our rules. You came back as yourself (Shannon Russell) and while you have hounded people and come very close to crossing many lines, we have allowed the discussion to proceed despite the fact it is about the ads instead of the medical issue. As the managers of this community, we would like to remind everyone to please remember your filter and participate in the conversation in a way that is courteous towards others. From now on, we will be asking those we think are being rude to repost their comments in a more polite manner. Thank you for respecting our community and continuing the conversation.

So, abusive comments are not allowed toward Children’s Healthcare of Atlanta (CHOA), the organization running Strong4Life, but abusive comments toward their critics is. Likewise, despite what the NIH says, there is no evidence that billboards stigmatizing fat children have any negative long-term effects. Meanwhile, S4L has their own research that says the result of their campaign is nothing but sunshine and roses, yet they will not allow the public to see it. Got it?

For the record, I was unaware of the fact that I was previously expelled for encouraging people to call the people responsible for this campaign. I never encouraged hate calls, but I did encourage, but I did suggest that people tell Strong4Life exactly tell them exactly what they think of the ads.

Now, maybe I should have encouraged people to be respectful, but in my rush to respond to a perceived crisis, I created an awareness campaign that had unintended consequences. And since none of the targets of my campaign ever called me to complain about the abuse they were receiving, I had seen no evidence that this phone-in campaign was harming Children’s Healthcare of Atlanta, the organization responsible for Strong4Life. Furthermore, while our critics presume to know the effects our phone calls will have on administration and staff of CHOA, our fatties see the true effects of stigmatization in our lives every single day.

For now, let’s just say that that we felt we needed to send a strong message to raise awareness of a serious issue.

But I’m touched that you’re so concerned about me and my health. If you could see me right now, you’d notice a single tear rolling down my cheek.

If you’re new here, then you probably read about us in this BBC news story. You’re also probably wondering why the hell we’re so proud of being fat.

Well, for one, we’re not proud of being fat. We’re proud of being kickass, awesome people who just happen to possess a few more fat cells than most. But what makes us awesome is not that collection of fat cells, but the people behind the fat cells who society neglects in the pursuit of “health.”

By the current, socially-accepted definitions of health, thin=healthy and fat=unhealthy.

We disagree. We believe that health lifestyles=health and unhealthy lifestyles=unhealthy, but even that is subject to the whims of genetics, the social determinants of health and just plain luck.

But lifestyle choices are more than just what we eat and how active we are. People have the choice of whether to smoke or not, drink or not, go tanning every day or not. All of these choices, along with diet and exercise habits, contribute to your overall health matrix. Focusing on any single risk factor is penny wise, pound foolish.

But we understand the desire to address obesity. The media is filled with stories of the ravages of obesity. So, you come here and you want to know how we respond to the health issues associated with obesity.

Fair enough.

Behind the scenes in the medical community there is a seismic shift taking place. Dieting has a well-documented history of failure rate, and the repeated attempts to lose that weight, followed by its inevitable regain, is known as weight cycling, the health risks of which broadly accepted (PDF).

Yet physicians continue to recommend weight loss as the “cure” for obesity despite no evidence that long-term weight loss is sustainable for the vast majority of people. Instead, physicians are recommending a modest weight loss of 5-10% of your starting weight. For a 5’7″, 265 pound guy like me with a BMI of 41.5 (aka morbidly obese), that shakes out to a weight loss of 13-26 pounds. At a weight of between 239 and 252, that gives me a BMI of between 37.4 and 39.5, on the cusp of morbid obesity.

I still look fat, but that little bit of weight loss has made a profoundly positive impact on my health. Why? Is it because I have five less pounds of fat cells on my body?

No.

If that weight loss occurred because I transitioned from an energy dense diet and sedentary lifestyle to a diversified, healthy diet and an active lifestyle, then this may effect my weight, but the loss of the weight itself has little to do with the actual health improvements. What matters are the lifestyle changes I have made, which may, or may not, result in a 5-10% weight loss or more or less.

By hyperfocusing on the importance of weight loss, we have done a disservice to the true goal of healthcare: making us healthy. If we follow the evidence — evidence like the decades of work behind Dr. Stephen Blair’s fitness research — we find that weight loss is not necessary to improve one’s health, but lifestyle changes are.

This approach to healthcare has a name: Health At Every Size^® (HAES), and it is an evidence-based approach to healthcare that focuses on emphasizing lifestyle changes and deemphasizing one’s weight status.

“But if you don’t look at the scale, how do you know if it works?” This question stems from a weight-based metric of health. In this model, fat is the disease-causing agent and losing fat is the cure. But the propensity of research does not support this model.

In the world of research, the true disease-causing agent is insulin resistance (IR), or the body’s inability to process one’s blood sugar. If left unchecked, IR can ravage the body, triggering a whole host of metabolic disorders that can lead to impaired morbidity and mortality. IR is a greater indicator of risk for heart disease, type 2 diabetes, hypertension and, yes, obesity.

But not all obesity is caused by IR. We also live in a world where poverty and education, medication, chronic stress, lack of sleep and our newly emerging understanding of endocrine disruptors in the environment have all been implicated in rising obesity rates. And you know what else has been implicated? Weight cycling.

That’s right: dieting leads to weight cycling leads to long-term weight gain.

By taking the focus off of weight and putting it where it belongs — onto IR — HAES offers a reasonable alternative for people who are looking to get healthy and who aren’t interested in jumping back on the diet bandwagon.

HAES has three basic tenets.

1. Eat a healthy and diverse diet, paying attention to your body’s natural cues of satiety and craving
2. Move your body in a way that you enjoy and that is sustainable
3. Love your body as it is

Now, before you dismiss me as a crackpot hocking a new diet fad, a similar approach to healthcare has been advocated by none other than Surgeon General of the United States, Regina Benjamin:

And the national media is beginning to take notice, including the National Geographic and MSNBC. And unlike the traditional weight-based focus on healthcare, HAES has a growing catalog of research that positive long-term health outcomes for its adherents, regardless of weight.

But you’re still skeptical. I completely understand, and I, and my fellow bloggers, are always open to questions, comments and criticism, so feel free to challenge us below.

One word of caution, though: we don’t call ourselves Fierce, Freethinking Fatties for nothing. Any abusive or disrespectful comments will be subject to the Asshole Rule. If five people tag you as an asshole, your comment will be deleted. If you have three comments deleted, you have earned yourself a permaban. So, by all means, ask questions, just don’t be a douchebag about it.

Finally, if you want to learn more about HAES, please visited the Association of Size Diversity and Health, a coalition of healthcare professionals who are committed to spreading the word about HAES. There’s even a great blog filled with excellent resources.

And finally, just to quell that nagging feeling that we must be selling something, there’s a book called “Health At Every Size” written by Dr. Linda Bacon (we know, ha ha, bacon), which reintroduced the concept of HAES and has an incredible amount of research and information on how you can incorporate HAES into your life.

Thank you for visiting us today, and if you have a moment, please consider donating to our billboard campaign to combat the effects that the Strong4Life campaign has had on the children of Georgia.

Thank you.

Peace,
Shannon Russell
Editor-in-Chief of Fierce, Freethinking Fatties.

The power of Dan Savage compels you!

The power of NEDA compels you!

The power of Kaiser Permanente compels you!

And now… the power of the NIH compels you!

That’s right, after writing to three divisions of the National Institutes of Health (NIH), I received the following response on from the National Institute of Child Health and Human Development (NICHD) on January 25:

As a federal agency, the NICHD and its employees are prohibited from endorsing or condemning a specific private health care provider or person, organization or facility, or campaign or product. This prohibition includes issuing a statement for or against a campaign or product.

I asked the representative if they could issue a statement condemning the use of stigma and shame against fat children in public health campaigns. She responded:

While I can fully appreciate your perspective, and while I personally share your feelings that stigma and shame are not useful or effective ways to encourage change, the Institute cannot make a statement either way. There is neither authority nor precedent for it to do so. [emphasis mine]

Since then, I hadn’t thought about it. Government agencies don’t comment on private health care providers. It makes sense. It’s sound policy. I let it go.

Yesterday, I received an email from the NIH which has absolutely floored me. Dr. Alan Guttmacher, Director of the NICHD, sent me an official statement, on letterhead and everything, not only condemning shame and stigma, but calling out Strong4Life by name.

Check it out!

Dear Ms. Russell: [ed. note: Stop giggling]

Thank you for writing to the National Institutes of Health (NIH) concerning the Strong4Life campaign that targets overweight children in an effort to curb childhood obesity…

I agree with you that this campaign carries a great risk of increasing stigma for those children who are overweight or obese which, in turn, can reinforce unhealthy behaviors (e.g., overeating). A number of research studies over the last decade have supported this concern. For example, studies suggest that overweight children who are teased about their appearance are more likely to binge eat or use unhealthy weight-control practices, and weight-based victimization has been correlated with lower levels of physical activity. Not surprisingly, stigmatization of obese individuals, particularly adolescents, poses risks to their psychological health.

Other studies show that the perception that obesity is solely a matter of personal responsibility, as opposed to understanding the complexity of contributing factors, can increase negative stereotypes of overweight people. It is important, therefore, that public messages about obesity address this complexity whenever possible.

Bear in mind the comment from the previous emails: this is an unprecedented condemnation by the NIH of a private healthcare organization’s public health campaign. When the NIH begins bending rules to send a message that you are harming children, it’s time to listen.

Plus, in the near future, First Lady Michelle Obama will be answer this question from Angela Black, a Georgia native who has seen the damage done by this campaign first hand. There’s always the chance that the FLOTUS will say, “Well, we have to do something,” but given the coalition of forces who have taken a stand against this shameful ad campaign, I seriously doubt it.

And this is just the beginning. We are only getting louder and we will not stop until every single billboard comes down and Phase 1 of the ad campaign ends.

In the meantime, we still need your help to wrap up our fundraiser. We are just 98 donors short of unlocking the $5,000 More of Me to Love Match. So please donate your Solidarity Dollar today and help us end our Phase 1 of our billboard campaign.

After I was banned from Strong4Life’s Facebook page for saying “Shame on you” (vulgar, I know), I began making comments from my personal Facebook page which is just for the people I know in real life. Part of me was concerned because every comment I made on Strong4Life would be broadcast to my family and friends, some of whom I knew would not exactly be sympathetic to my side.

The worst I feared was a confrontation at the next family gathering, where I would have to go full-on fat activist to get my point across. What I didn’t expect was for my sister-in-law to “like” Strong4Life’s comments and to begin commenting in support of Strong4Life.

I have tried to explain that we are not against public health campaigns that encourage families to eat healthier foods and get more exercise. We fully support that. What we are against is the exploitation of fat children and the use of shame and stigma to “shock” people into action.

Her response?

I may not agree with all of the angle this add campaign is taking but I applaud them for trying to wake Georgia up and make some change happen.

and

I am not defending their ads. As I said in a previous post I do not agree with all of their tactics they have used to get their point across. What I am for is the fact that they are trying to do something.

She then went on to explain how the ads are necessary to get parents to break the cycle of unhealthy lifestyles. As far as she is concerned, the blame lays squarely with the parents and if this campaign gets parents to do something about it, then this campaign has been fully justified.

[Ed. Note: I just received word that my sister-in-law has been receiving hate mail. Please do not do that. My public rebuking of her is enough. My only reason for mentioning our relation was to illustrate how shocked I was at the proximity of Strong4Life defenders, not to sic the dogs on her. So, please, don't contact her. Thanks!]

I keep seeing a similar justification on Strong4Life’s Facebook page, where people say that the ad campaign may not be the best approach, but that they have to do something to get parents involved because parental involvement will solve this crisis.

First of all, I find these views reprehensible in the strangers I have been debating online. I have found myself wondering just what kind of monster would say that in this case the ends justify the means. Now I come to learn that someone who I had admired for her compassionate spirit is essentially saying, “Yeah, do whatever needs to be done to ‘fix’ the problem.”

But these kinds of justifications remind of the saying, “Don’t use a hammer to swat a fly on somebody’s head.”

On January 23, the American Heart Association issued a scientific statement titled “Evaluating Parents and Adult Caregivers as ‘Agents of Change’ for Treating Obese Children: Evidence for Parent Behavior Change Strategies and Research Gaps,” and what it has to say about the effect of parental influence on child’s weight is quite intriguing in light of this last-gasp defense of a dehumanizing campaign.

The statement explains the most successful core behavior change strategies for obese children, followed by a review of 12 studies that compared the effect that parents and adult caregivers (PACs) can have using these strategies. The studies took care to control for PAC involvement:

[W]e specifically sought studies in which competing treatment arms provided the same or a very similar behavioral intervention to families with the exception of parental involvement, which was determined via random assignment. We did not focus on studies in which the main comparison was a family-based treatment package versus no-treatment control or an educational control, or a comparison of active treatments that had similar parental involvement.

So, the meta-analysis looks strictly at the effect of parental involvement on the success of pediatric obesity treatments, which is what defenders of Strong4Life say is the justification for using such a harsh advertising campaign. The ads are designed to get parents attention because 75% of parents are clueless and the only way to put an end to childhood obesity is to get parents to take responsibility for their actions.

This AHA scientific statement measures exactly how much of an effect parental intervention will have on the success of childhood obesity interventions. So, how’d they do?

Only 2 (17%) of the 12 studies100,113 found significant short-term differences in child weight status outcomes among interventions that varied the degree or nature of parental involvement, and only 3 studies (ie, 25%) reported long-term differences. This provides limited support for the notion that greater parental involvement with their children in treatment leads to stronger outcomes.  [emphasis mine]

It’s funny how 3 out of 12 studies is spun into “limited support” for the notion that parental involvement is what is missing here. Later, the study expands upon this “limited support” notion:

In summary, results from randomized clinical trials provide mixed support for the notion that greater PAC involvement leads to better child weight control. The majority of studies did not report significantly better weight loss outcomes for children whose parents were more involved in treatment, a conclusion reached in certain prior reviews.

By “mixed support” they mean that three-fourths of the studies showed no correlation between PAC involvement and better outcomes. And, lest you blame the parents in the study for the failure, the scientific statement includes this gem:

An important caveat to these conclusions is that the studies generally were conducted with self-selected, highly motivated families who were willing to undergo intensive counseling. White families also have been overrepresented in these studies; future studies must examine a more diverse range of families. [emphasis mine]

Even when the people involved in the treatment are highly-motivated to seek intensive counseling, PAC-involvement made little difference in the success of the program. Of course, “success” has been defined as “better weight control,” and we already know the outcomes of weight control efforts, which are consistently disappointing for those who use weight as a proxy metric of health.

Other studies cited in the AHA’s statement indicate that parents who role model healthy behaviors account for just 25% of the variance in two-year weight loss outcomes. So, even when parents model healthy behaviors, 75% of the reasons for their weight loss has to do with something other than parental modeling.

So, if it isn’t apathy, if it isn’t poor modeling, that prevents kids from being “cured” of their obesity, then what is it? The AHA says, “That family history of obesity and genetics put certain children at greater risk than others for becoming obese is generally accepted.”

Genetics, eh? Go on…

Childhood obesity has a significant genetic component, as do several eating behaviors that may contribute to obesity onset. Examples include rapid eating rate, poorer recognition of internal satiety cues, greater responsiveness and eating in response to environmental cues, and a heightened tendency to eat in the absence of hunger when exposed to palatable foods. Genes also influence habitual physical activity levels. Indeed, genes also may influence children’s improvements in weight status in response to a family-based treatment.

The authors go on to suggest that awareness of these genetic influences might help parents.

Might knowing that one’s child has increased susceptibility to obesity enhance PAC motivation for behavior change? Or might this lead to a decreased sense of self-efficacy or hopelessness?

I find it odd that in a study which concludes that a group of highly-motivated PACs made little difference in obesity treatment would go on to suggest that more motivation is needed, as opposed to, say, looking at other ways of improving the health of children.

The authors do make one practical suggestion that I found intriguing.

There is evidence that bolstering peer support may enhance lifestyle interventions for childhood obesity, and this may be a novel component to address in future parenting interventions. [emphasis mine]

I’ve got news for you AHA, to say that the effects of stigmatization and public shaming by peers, or a multi-million dollar ad campaign, are bad for a child’s health, and that bolstering support for fat kids may help a child’s health is not a “novel component.”

The Yale Rudd Center for Food Policy & Obesity has been telling people for years that media portrayals of fat people, as well as the stigmatization of fat kids, are bad for our health.

Although Strong4Life and its defenders have cited the failure of parents to be the justification for waging a NINE MONTH War on Fat Children, the evidence that parents need a “wake-up call” is sorely lacking, according to one of the premier public health organizations in the country, the American Heart Association.

Aside from the genetic component, I would also urge people to learn more about the social determinants of health, which have a much bigger impact on the choices parents make in terms of nutrition and exercise. Childhood obesity is a complicated issue, and simply blaming parents and shaming kids will not produce the desired results. There is plenty of blame to go around.

In fact, the AHA study had one intriguing nugget to say about who’s at fault for childhood obesity.

You recall the infamous, unfounded 75% statistic (DAY 28 since we were promised the data from that study). Well, turns out, parents in Georgia aren’t the only ones in need of a wake-up call:

Another report of 87 primary care pediatricians and nurse practitioners found that only 26% knew the definition of childhood obesity and 9% knew of its prevalence.

You have GOT to be shitting me.

If the whole “raising awareness” thing is the main thrust of Strong4Life’s ad campaign, then maybe it’s time we start stigmatizing pediatricians and nurse practitioners:

If you want to send a message that there is no justification for stigmatizing fat children, then donate just ONE DOLLAR to our Solidarity Dollar campaign. We need just 174 people to unlock the More of Me to Love Match. Help us reach our goal today so we can get to work on creating a dynamic, positive campaign that will send a healthy message to ALL of Georgia’s children.

Without the context of the ads, this photo by itself strikes me as something out of a Calvin Klein jeans commercial.

Or maybe he’s advertising his new fragrance… it’s hip, it’s bold, it’s fat, it’s you: Bobby.

Likewise, the girl with the folded arms?

She looks like a badass. Like she’s these rugby players’ little sister.

It was only after the fact that I found this photo of her rugby team picture.

And, I’ve heard that she’s been moonlighting as a bouncer at Club Fatty.

She learned the craft from her dad.

This is just a reminder that context is everything. Unless you remind people that these children are poor, contemptible fatties in need of pity, scorn or salvation, then they might see them for who they really are. For example, don’t forget that sad, suffering Maritza…

Is really healthy, talented and confident actress Chloe McSwain:

If you want to change the context in Georgia, then help us out by donating just ONE DOLLAR to our Solidarity Dollar campaign. We need just 200 people to unlock the More of Me to Love Match. Help us reach our goal today so we can get to work on creating a dynamic, positive campaign that will send a healthy message to ALL of Georgia’s children.

Do you think it’s fun for me to write about the same subject day after day after day after day, trying to think of new angles, or digging up new dirt, on an organization that I otherwise couldn’t give two shits about?

I only have so much creative energy on hand each day and this project has been the Hummer of psychic fuel consumption. I’m happy to spend it fighting against bigotry, ignorance and hatred, but I, for one, can’t wait until the billboards come down and we can all go back to whatever it was we were doing before all of this began.That includes Children’s Healthcare of Atlanta. I don’t think they want to be deal with a bunch of pissed off fatties, or continuously develop new and interesting justifications for their sinister ad campaign which may or may not be profiting their weight loss and weight surgery center.* They’re just as sick of our shit as we are of theirs.

Isn’t it time we all said, “Enough” and wrapped up our respective campaigns?

With approximately 280 more donors needed to unlock the $5000 More of Me to Love Match, our goal of 1,000 donors is just out of reach. Once we reach that goal, we have decided to end the donation phase of our project (see how easy it is to switch from phase to phase, CHOA?) and begin the development phase of our Billboard Project. This will cap our advertising budget around $20,000, which is plenty for our needs.

So, I want to ask you all to help us throw a one-two punch today. There are two simple forms of armchair activism which will help us achieve our duel goals of ending the fundraiser and pressuring on CHOA to bring Phase 1 to a close. They’re pretty basic:

1. Ask one person to donate $1 to our Solidarity Dollar campaign, or donate yourself
2. Comment, like, and share my question for Michelle Obama on CNN iReport and/or ask your own

We can easily reach our goal of 1,000 donors today if everyone who reads this blog on a regular basis asked just one person to donate a Solidarity Dollar. So, please help us reach that goal today.

And if you want to see the First Lady give her opinion on Strong4Life, then we need to make it impossible for her to ignore our voice. With every question, comment and like, we improve our odds that she will hear our question.

I have a hard time believing that, in spite of the misguided, but well-intentioned, Let’s Move program, Michelle Obama would approve of the advertising campaign used by Strong4Life. If we can get her to discourage the use of such tactics, we would have a powerful ally in our corner.

So, please, take a moment and help us say ENOUGH IS ENOUGH and bring both of our campaigns to an immediate close. Thank you!

We need 1,000 people to donate to unlock the MOMTL Match and until we reach that goal, we are holding our fresh, daily content hostage.

There’s one catch… the Go Fund Me site where we launched our Big, Fat Moneybomb will not accept less than $5, and we know that in this economy, that can make a major difference. So, Ragen has set up this PayPal donation site for people to contribute between $1 and $5, This is specifically for people who want to show their solidarity with Stand4Every Body, but don’t want to break the bank in doing so. That’s why we’re calling these donations Solidarity Dollars.

Every Solidarity Dollar brings us closer to our goal of 1,000 donors. We already have 72 Solidarity Dollar donors, bringing us to a total of 485 donors, including the moneybomb.

We are halfway to our goal and halfway to an additional $5,000 from More of Me to Love, all of which goes to our media campaign in Atlanta.

Please give any amount to our Solidarity Dollar campaign so that we can get back to the business of kicking some ass fatly.

And if you can afford more, please give generously to the main donation site, as we will continue raising money throughout Fatty February to build a robust response to Strong4Life and Children’s Healthcare of Atlanta.

Alright people, listen up… you’re not getting any fresh content until you donate to our Big Fat Moneybomb, got it? We’re already halfway to our $10,000 goal (which means we’ve met half of the More of Me to Love Match) and I haven’t even finished my fucking oatmeal. Every dime above that $10k will go to an extended media campaign, whatever will fit our budget. So give what you can because in order to unlock the MOMTL Match we still need 1,000 donors.

Every penny counts, so head over to our donation page and keep pushing that total skyward. The children of Georgia are counting on us!

And once we unlock the MOMTL Match, we’ll release the fresh content.

I figured there was no harm in asking Strong4Life and Children’s Healthcare of Atlanta to pitch in some as well.