Why I’m Never Again Donating To Cancer Research UK

Well, this probably seems uncharitable, but here are my reasons why I will never again be donating to Cancer Research UK (CRUK).

Don’t get me wrong, if you’re a friend of mine, and you’re planning on running, swimming, knitting in a bath of custard etc in future and need sponsorship, I will happily donate to a charity in recognition of your efforts. But not to CRUK. You can pick another charity. You can choose one doing great work in cancer treatment or care or awareness or research; Macmillan, Marie Curie, Breast Cancer Now, there are hundreds! Just not Cancer Research UK/Race For Life/Stand Up To Cancer, which are many faces of the same charity.

Why? What’s wrong with Cancer Research UK?

Maybe it’s just me, but I’d hope that a charity which puts research at the forefront of its identity (it’s in the name, for heavens’ sake!) would understand the need to not make wild claims. I’d hope they understood the difference between causation and correlation – it’s usually taught in secondary schools! Here’s a really useful TED talk explaining the danger of mixing correlation with causation:

So we can see from the example given in the video (if you’re reading this on mobile data and don’t want to watch it!) is that just because the incidence of drownings increases when the sales of ice creams increase (a correlation), does not mean that we can infer ice creams are responsible for drownings (causation). Or conversely, decide that drownings are responsible for ice-cream sales!

We can suspect one leads to the other. We can theorise what might cause this, but without further evidence it is merely a theory. It may be difficult to prove. That doesn’t mean you can ignore the lack of proof and state it as fact for the sake of convenience. Furthermore we must not forget to look for other influencing factors which might explain both results, like the weather, in the TED example.

So, where does Cancer Research UK come into this?

CRUKs 2018 OB_S__Y is a cause of cancer ad campaign.

When CRUK released their ad campaign last year stating, quite categorically, that obesity causes cancer, I was a bit concerned. I knew of the link between being of higher weight and increased risk of certain cancers (and decreased risk of others that we rarely hear about!), but there has never been proven causation. Yet CRUK were happy to state it.

Wait, obesity isn’t a cause of cancer?

No one (and there’s been plenty of research!) has yet proven that obesity causes cancer. It is possible that there is a causal link, of course. The theories may be spot on. I don’t deny that. But you’d hope a charity spending hard-won donations, and with ‘research’ in their name, would be a bit more responsible and careful not to overstate a theory as fact? It’s an important distinction.

As with the TED analogy, research has suggested that common factors could be responsible for the connection. Genetics are particularly suspect. Did you know tall people are more likely to get cancer than short people? Don’t see them putting that on a bus shelter, or claiming that height causes cancer. It’s an accepted correlation. Strangely CRUK don’t feel the need to make anyone feel crap about being tall…

But being fat’s not the same as being tall!

“But people can’t help their height!” I hear the virtue-signallers cry! “It’s not the same! Fat people can lose weight!” (with a in implied side-order of “they’re just lazy/stupid/lack willpower!”).

Except if you’re overweight, and have always been overweight, come from a line of people who are and have always been overweight, and have repeatedly watch them try and fail to lose weight, you know that while the maxims of ‘just lose weight’, ‘just eat less’, ‘just exercise more’ sound so deceptively simple in theory, they’re incredibly difficult in practice.

Of course, there’s always surgery, the one reliable intervention to lose weight – but if that’s so desirable, why wouldn’t we suggest tall people lop off a couple of inches to reduce their cancer risk? (I’m not suggesting that either!) There are significant risks associated with surgery, and significant downsides. It is not a one-size-fits-all solution. Yes. Pun intended. Let’s not lose sight of the fact that there’s a lot more to being healthy than merely a BMI.

But obesity IS preventable! You just don’t want to hear the truth!

Many overweight people struggle with their weight their entire life. Many lose weight, only to put it all back on again and more, often over and over, getting bigger with every cycle. We know this, and we don’t fully understand why. But we’re beginning to understand that willpower and behaviour are probably only a small part of the puzzle, maybe as little as 5%, with many other factors coming into play .

If it was so easy, Slimming World and Weight Watchers would have gone out of business years ago. The fact of the matter is that their business model works precisely because most people don’t and can’t lose the weight and keep it off long term in our modern society. We know this. It’s a problem we’ve been trying to solve for years, and CRUK campaigning that obesity is a ‘preventable’ cause of cancer completely ignores this.

Every time I drove past one of the CRUK adverts last year it irritated me. I knew it was inaccurate, felt it was irresponsible, and I was frustrated that they were choosing to oversimplify a complex problem as a personal failing. I, and many others felt it insidiously feeds the narrative of blame and shame that is so common with obesity.

It allows those who don’t have a high BMI to feel just that bit more smug, just that bit more superior; safe in the knowledge that their predominantly genetic disposition to not be overweight is saving them from cancer, with the added implication that us fat people should really do something about it for the sake of our health…

Maybe they didn’t realise…?

Not everyone reacted as mildly as I did, of course…

But those ads didn’t quite push me to the point of saying never again will I be donating to Cancer Research UK. That only happened this week…

I decided to give them the benefit of the doubt last year. Maybe they didn’t realise? Perhaps they felt the shock factor they wanted to use outweighed the risks of that approach and misjudged it? Maybe in wanting to keep the message simple they went further than they should have in overstating the point, but have learned from it?

So, what happened next?

Firstly, don’t be tempted to read the responses Sofie Hagen received on Twitter. Let’s just say plenty of people decided to tell her she was wrong. Haters gonna hate and all that… We don’t need that kind of negativity!

The campaign garnered lots of attention, was widely accused of fat-shaming and stigmatising obesity, and lauded by others for ‘telling it like it is’ (or as we know, isn’t, but hey-ho). These comments mainly came from smug-thins who think it’s simple to solve the ‘obesity problem’; just regularly tell fat people how crap they are and they’re sure to take it on board…

It also prompted amusing but entirely predictable responses implying the only reason people are overweight is because they eat fast food… yawn. Never saw that one coming. Oh, wait. Yes we did. It’s exactly these kinds of lazy tropes and attitudes that such a campaign fuels and that we’re entirely sick of.

Didn’t anyone explain to CRUK where they’d gone wrong?

Of course! Aside from the discussions on Twitter and in the media, various organisations and experts connected to the study of obesity contacted CRUK to offer their services.

They told CRUK how the adverts were stigmatising and misleading. They explained how simply telling people with obesity that they’re at increased risk of cancer does nothing to help, but does everything to make people feel more marginalised. Experts met with CRUK to explain how a more useful and sensitive campaign could be launched in future…

So, what happened this week?

Cancer Research UK's latest ad campaign - comparing obesity to smoking.

This week, CRUK went one further with this ad campaign.

Cigarette packets branded with “Obesity is a cause of cancer too”. Eyecatching and emotive, certainly. Accurate and helpful? Not so much.

Marvellous. They’ve taken on board precisely …erm… nothing at all from last year’s campaign feedback!?

Or perhaps they enjoyed the publicity last time?

Good grief, I feel sorry for the people who gave up smoking and gained weight as a result. They must feel like they can’t do right for doing wrong! They’re probably having their nicotine addiction triggered by the enormous images of cigarette packets, all while wanting a cigarette to deal with the stress of finding out that they’re doomed to get cancer…

Of course, the media reported the release like this:

Google News search for 'cancer obesity' showing misleading headlines and the standard 'headless fat body' image

With the word ’cause’ prominently repeated, with images of fast food and headless fat bodies galore – despite organisations such as the European Association for the Study of Obesity and The World Obesity Federation campaigning widely against such reporting and providing and free usable non-stigmatising images… Here we go again. Entirely predictable. Blame and shame. Emotive stuff.

There was a swift backlash. The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (what a title!) wrote this great article:

Only this time there’s no room for the benefit of doubt; CRUK know these campaigns are hurtful, and they clearly don’t care.

And then, despite the complaints, CRUK continued the narrative this morning by tweeting this:

What, are we just pointing out random statistics we observe now? No. Clearly CRUK has decided this is the hill they want to die on; might as well be hung for a sheep as a lamb. If you don’t like it, go chew some obesity gum or puff on your obesity inhaler… Oh, wait…

Cancer Research UK Budget

Here’s how much CRUK spends in a year.

Caner Research UK's 2017/18 Budget spend by sector (total £652m)

It’s a lot. A sizeable amount is spent on research. So far so good. But when £43 million pounds in 2017/18 was spent on ‘information and policy’ (admittedly, it’s only half of what they spend on raising the cash in the first place…), and when that information and policy is based around misrepresenting that research, enough is enough.

What does CRUKs CEO have to say?

Luckily not all media outlets have responded to CRUKs latest campaign by parroting it blindly… Sky News at least have responded by reporting some of the criticisms the new campaign has received:

https://news.sky.com/story/cancer-research-advert-criticised-for-comparing-smoking-to-obesity

They even quote CRUK chief executive Michelle Mitchell:

“We have a responsibility to tell people about what might increase the risk of cancer.”

Yes, Michelle. Might. So why are you so ready to be certain that it does cause cancer when you’re plastering it on a poster?

I might never again donate to Cancer Research UK. Oh, actually sorry, no. I’m never again donating to Cancer Research UK. Put that on a poster, Michelle.

Boycott Trash Mags

The cover of Bella Magazine: “Claire’s Weight Misery – Two stone heavier after time abroad”, right next to an advert for a £4.99 ‘wonder serum’ and underneath “Fat Blast Diet – Lose 20lb this month”. A masterclass in how to make women feel inadequate and then try to sell them something to fix it.

Claire Sweeney on cover of Bella magazine - titled 'Claire's Weight Misery'

Shame on @bellamagazineUK for publishing this, and hurrah for @clairesweeney for calling them out on it, particularly as it comes during #MentalHealthAwarenessWeek. #BoycottTrashMags

Why do editors continue to peddle this crap? Such lazy and vindictive journalism; find an unflattering picture of someone and then write some nonsense piece to go with it about how their life must be falling apart, usually with no factual basis whatsoever. Surely this wasn’t why they chose a career in journalism?!

The trouble is, we all know why magazines and newspapers do this; celeb character/image assassination sells. Daily Fail’s sidebar of shame is testimony to that; people love to gawp and revel in the misfortunes of others. But why?

What is it about our society that loves to build people up and then knock them down again? How is it OK that a celeb can be the darling of a publication one week and their metaphorical punching bag the next? Why is this form of public bullying still acceptable, when it’s the publishing equivalent of throwing rotten veg at someone shackled in the stocks?

As a person who hasn’t bought a magazine in at least a decade, this both fascinates and concerns me. Is my lack of attention to these magazines one of the reasons why I am happy in my own skin, perhaps (and why I spend very little on expensive skin and make up products, ha ha)?! Surely this spiral of judgement and derision isn’t helpful for anyone’s self esteem?

Here are my top tips for banning the negativity, and hopefully feeling lots happier about yourself as a result!

  1. Don’t allow trash publications in your house. Don’t buy them, don’t feed the monster. It’s bringing us all down.
  2. Recycle any that are in your house. If you’re keeping it because you find an element useful, take a snapshot, file it in a virtual folder and get rid. In future, source whatever it was elsewhere; you can get tons of recipes online and even see others’ reviews before going to the effort. If it’s makeup tips you’re after, maybe watch some YouTube make up tutorial channels. If it’s fashion you’re interested in, there are plenty of fashion blogs you could subscribe to, you can probably even choose one which more closely fits your kind of style than the generic offerings you get in magazines. If it’s the puzzles you like, there are numerous free apps. The only thing you actually have to give up is the celebrity gossip – and think of that as negativity decluttering!
  3. Don’t even read them while waiting at the doctors/dentists/hairdressers. The articles in these magazines, whether praising someone’s appearance, or criticising someone else’s, just feed into the idea that appearance is worthy of judgement. It isn’t. If they/you feel good that’s all that matters. Read a novel/non-fiction magazine/do sudoku to fill the time instead!
  4. Check your impulses to criticise others, even if you were only doing so mentally. It takes a while (particularly if you have grown up amongst relatives who like nothing more than to gossip and criticise!) to retrain your brain not to look for imperfections, but when you start to notice all the instances you would have said or thought something critical, you realise how much you were focusing on and feeding negativity. You can change this habit, and it gets easier as you keep doing it!
  5. Feel free to notice and compliment other people’s appearances instead! Everyone feels great when someone gives them a genuine compliment, especially if it’s a stranger so there’s no suspicion of an agenda – if you think someone’s hair/shoes/clothes are great – tell them! It’ll make their day, and will give you a warm fuzzy feeling too.
  6. When people compliment you, don’t brush it off. It’s tempting to negate nice things people say about us, sometimes because we feel it’s endearing to be self-deprecating, sometimes because we’re uncomfortable hearing nice things said about us. But that person took the time to say something nice; own the compliment, say thank you, and smile!
  7. Compliment your children on more than just their appearance. It’s nice to think our daughters are pretty and our sons handsome, but what about looking at other personality traits, like commenting on kindness, bravery, innovation, and perseverance?
  8. If you have children, talk to them about advertising, airbrushing, and unrealistic beauty standards, and how the advertisers who pay for the publications need you to feel insecure so they can sell you products to make you feel better about yourself.
  9. Be fabulous in your own skin!

In response to this Bella cover, Twitter is now awash with people sharing pictures of Claire Sweeney looking svelte and glamorous at events she’s attended over just the last couple of days. She clearly hasn’t gained 2 stone recently at all.

Ironically their meanness has led to lots of positive publicity. But even if she had gained weight, why would that be evidence she is miserable?

Again, kudos to Claire – she hasn’t posted any pictures of herself to prove lack of weight gain and refute the magazine’s claims – that’s no-one’s business, and would just perpetuate the myth that fat = unhappy. She just replied with the hashtag #nomisery. Respect.

It’s time to #boycotttrashmags.

Reflections on Primary Care and Public Health Conference 2019

Well, that sure was an exhausting but very worthwhile couple of days!

NEC Loading Bay – Hi-vis really sets off my outfit beautifully!

As my first experience as a conference exhibitor it was possibly a bit of a baptism of fire doing two days @PrimaryCareShow, plus set-up and take down. Definitely a steep learning curve, but really excellent to have the opportunity to put our Parenting Science Gang Research findings before a wider (and very receptive) audience!

Met many, many lovely healthcare professionals across the two days, the vast majority of whom are totally sympathetic to the rough deal bigger mums often experience, and are all too aware of some of the hurtful and unnecessary things that can be said and done while navigating maternity services; some of whom knew from personal experience!

Some interesting discussions too with healthcare professionals who clearly thought their practice was empathetic, encouraging, and open, but whose use of language belied a weight bias, or a propensity to be dictatorial in their provision of care…

What Women Wanted
Postcard – Words used by women in our research to describe the birth experiences they hoped for

Did they notice my (hopefully subtle) efforts at positively reframing their words? Who knows, but I didn’t get into any heated debates, so my challenging of attitudes was at least successful in that I seemingly didn’t make any enemies or get anyone’s backs up, I just hope my words didn’t fly completely undetected under the radar!

We did raise some eyebrows with some of the quotes from the research, even from very experienced midwives, and hopefully prompted some thoughts and reflective practice. Also gained a few new followers on Twitter and some new sign-ups to the Facebook chat group, hi if you’re reading!

Although most of the time was spent in the exhibition hall speaking to delegates, I did manage to get along to 4 conference presentations across the two days – two in the Mother & Baby programme and two of the Obesity & Weight Management sessions, with mixed reaction!

What Women Got
Words used by women in our research to describe their actual birth experiences

I was shocked and frustrated to listen to Judith Stephenson, a Professor of Sexual and Reproductive Health, waxing lyrical about a 2018 study which promoted a ‘drink only semi-skimmed milk for 8 weeks’ diet in order to facilitate rapid weight loss and thus be in a better position to enter into pregnancy – when all studies I have ever encountered suggest that restrictive diets and rapid weight loss do more harm than good, and while seemingly effective in the short term, are rarely successful in the medium to long term.

I was also frustrated that she feels that obese women planning pregnancy need to be told that they would decrease risks by losing weight. “This isn’t about blaming women” (except it sounds a lot like it!!). In my experience women are VERY aware that we should lose weight, and it’s not that bloody simple; repeatedly telling us this fact does nothing to help us, and just increases blame, guilt, and disengagement. If you actually want to help us, just ask if we’d like to do something about weight management/fitness or like to hear about local options available to help, and if we say no, move on!

I was at least able to put these points in questions after the session, and several attendees came and sought me out afterwards to thank me/agree/discuss further, so definitely glad I attended that one!

On the plus side, I do agree with her that healthcare services are missing a trick when women attending a family planning clinic for removal of a long-term contraceptive device are not given basic information about preconception health, e.g. to take folic acid, and offering signposting to services available to help with weight loss, smoking cessation etc. given that pregnancy is a very pivotal moment in a woman’s life and the likelihood is that we are at our most receptive and motivated to change any perceived negative behaviours, for the benefit of the planned-for baby.

I later attended an excellent talk by Debra Bick of the University of Warwick on the Care of Women with Obesity in Pregnancy which was far more supportive in the use of language, remembered that there’s often a husband or partner in this equation, and a really useful review of recent studies and their results – which I now need to seek out and read!

The following day was more of the same – firstly a really aggravating talk on
Weight Management During Pregnancy and the Post-Natal Period by
Dr Amanda Avery… who was billed as the chair of the BDA Obesity Specialist Group and an Associate Professor in Nutrition and Dietetics, but just so happens to be on the payroll of Slimming World and who uses a LOT of ‘they’/’other’ and presumptive-generalisation-speak when talking about women with obesity. Very judgemental/dictatorial/patronising – pregnancy is a “teaching opportunity”. All right, we get it: you’re not and never have been a fatty, and those of us who are overweight just need you to swoop in and educate us! Grrrrrr. Haven’t we moved on AT ALL?!?

She then went on to minimise the risks to the unborn of weight loss while pregnant, recommend Slimming World (of course!), push for encouraging obese women to lose weight while pregnant, and advocate for a return to weighing women at every antenatal appointment to encourage this – “it’s a low-cost intervention – you only need a set of scales!” – yes, that was dropped because it was stigmatising, anxiety inducing, disengaging, and showed no benefit to fetal and neonatal health!?! Then she suggested that the reason that childhood obesity has increased since the 1990s is because that’s when we stopped doing regular antenatal weighing! For goodness’ sakes – oversimplification maybe!?! I think quite a few other things may have changed in those two decades!?!

So. Many. Issues… I was really struggling to work out which points I was going to challenge about her talk when it came to question time – would it one of the above concerns, the persistent conflation of pregnancy weight gain with obesity, or for failing to adjust macrosomia figures to account for gestational diabetes… but no need – there was no opportunity for questions unless you stayed to listen to the following talk too! Arrrgh!

Fortunately my confidence was later restored by a lovely talk by Karen Gaynor, a senior dietitian from Dublin, talking about The Impact of Stigma and Bias in Obesity Treatment, who totally gets it: You want to build an inclusive empowering dietician service? Then ask your patients what they want and involve them in designing it!

Don’t push for dramatic and unachievable weight loss goals – 10% is about the realistic limit! Remember that around 85% of obesity is due to genetic factors – only 15% down to environmental factors, with only a proportion of that down to personal willpower. Never forget we’re in an obesogenic environment and change is a massive uphill struggle and life-long commitment! Don’t use shaming imagery – there are plenty of online free-to-use gallery images featuring empowering pictures of overweight and obese people (try https://easo.org/media-portal/obesity-image-bank/ ) – and if you see stigmatising imagery or language used in practice or the media, call it out!! Honestly, the talk, and the questions/comments from delegates which followed were so uplifting! What a great session to end on!

I totally need to namecheck our lovely neighbours at https://littlepeopleuk.org/ and https://www.burningnightscrps.org/ with whom we shared laughs (and confectionery when energy was flagging)!

Most special thanks go to (in order of appearance) the wonderful El, Serena, Mawgen, and Dani; who worked charmingly and tirelessly along with me (with the aid of sugar and caffeine) in talking to dozens? hundreds? (wish I’d had the foresight to bring a tally counter – lesson learnt) of healthcare professionals across the two days.

Lastly (this is starting to feel like an Oscar acceptance speech, I’m sure someone somewhere is frantically gesturing me to get a move on as the orchestra pipes up!) huge thanks have to go to The Parenting Science Gang for making this happen, and Wellcome for funding it!

Lots of contacts made, lots of thoughts provoked, lots of ideas forged, lots of avenues opened.

Big Birtha x

Post-show carnage
Post-show carnage

PCPH Conference Here We Come!

Well, this is exciting!

The banners are printed… Collecting the fliers tomorrow… We’re almost ready to unleash ourselves on unsuspecting delegates at the Primary Care and Public Health conference in Birmingham on the 15th and 16th of May!

This is all thanks to Parenting Science Gang, funded by Wellcome.

Representatives from the BigBirthas Facebook group will be staffing the stall, along with representatives from some of the other Parenting Science Gang groups, all eager to talk about our research.

The conference is free to attend, you can find details about it and register here: http://www.primarycareandpublichealth.co.uk/

Come over and say hi!