What Planet Are You On?

Over 80% of Americans don’t have a gym membership. The gym market is split among low-cost gyms with limited equipment and amenities, specialty gyms (for disciplines including powerlifting, weightlifting, climbing, or CrossFit), and “fitness clubs” with extensive services and amenities including training, massage, swimming pools, and so on.

Planet Fitness hasn’t tried to woo the less than 20% of people who already want to go to the gym – it’s gone hard after the other 80%, people who don’t like gyms, feel anxious in gyms, and may feel a need for fitness activity but probably don’t have performance goals. Planet Fitness tries to make going to the gym a fun thing with oft-derided events like bagel days and pizza feeds. This approach has kept it in business for more than 20 years. Unfortunately, in its zeal to avoid judging people for not being fitness freaks, it’s swung pretty far in the other direction.


Someone who judges – you mean, like, someone who uses
pejorative slang terms to refer to other people?

In a New York Times article about Planet Fitness’s marketing, Steve Red, the chief creative officer of marketing agency Red Tettemer & Partners (responsible for Planet Fitness’s recent “gymtimidation” campaign), was quoted about the aspirational approach to promoting health clubs: “I’m never going to get to be that washboard-stomach, super-cut guy that I see in the Equinox ads,” he said, referring to the chain of upscale gyms. “There are a ton of gym brands that are all about being cut and sinewy and having a six-pack, but I would argue that approach is not aspirational — it’s inaccessible.” (A Gym for People Who Don’t Like Gyms).

Planet Fitness doesn’t try to attract people who are reaching for the stars, whether in sheer amounts of weight lifted (its gyms don’t have the equipment heavy lifters need for training) or “perfect” abs (some argue the food offerings are part of a strategy to keep members feeling “failed” in fitness goals). A place you can go to get a nice bit of exercise, indeed where food is not “the enemy,” is a nice idea for a fitness company – it would be nice to see it done well.


A wild lunk appears! From one of Planet Fitness’s ads

But nobody likes being insulted. People who love heavy weight training, in particular, love to bag on Planet Fitness – and it’s easy to understand, when Planet Fitness has explicitly insulted and derided them in ads meant to show what their gyms are not. The hostility Planet Fitness expresses toward powerlifters and other gymgoers is offensive and contemptible, but it touched a nerve in Planet Fitness’s target market, as its “we’re not a gym” branding has done for years.

This tension and cliquishness has always bothered me. Both sides say some pretty wrong things. The “gymtimidation” campaign, with its laughable stereotypes and overt hostility, handily puts the lie to Planet Fitness’s claim of being a judgment-free zone, but a lot of responses in the fitness community haven’t exactly elevated the debate — and that helps to make life worse for everyone involved. Whenever I hear someone insult Planet Fitness members — not just the company’s marketing — as unrealistic or stuck in their own headspace, as weak-willed people that just need to suck it up and learn to work hard, I think, “You are the reason Planet Fitness exists.”

False Positives and Unintended Consequences

After an appendectomy, the removed appendix is examined to determine whether appendicitis (or some other problem) was present. In a noticeable proportion of people, it is not. This is not a problem, for a good reason: the consequences of untreated appendicitis can be swift and catastrophic. The consequences of appendectomy are, in general, mild by comparison, at least in societies with good sanitation. (There is always risk from surgery.)

This is being revised after trials with intravenous antibiotics have shown very high rates of survival, but appendectomy was introduced before the antibiotic era, many organisms are involved, and we’re losing antibiotic efficacy – plus appendicitis can still progress after IV therapy – so surgery still needs to be in the toolkit. Still, knowing that there are options well worth trying, and with a good track record, is good news for situations where surgery may not be available, practical, or advisable.

[T]ypes of patients in whom appendectomy might be avoided:

  • Patients with an appendiceal abscess, who would be better treated with percutaneous drainage;
  • Patients who have had a recent myocardial infarct;
  • Patients with severe lung disease;
  • Women in the first trimester of pregnancy; and
  • Persons in a remote environment such as Antarctica or on a mission to Mars.

From Evaluating Acute Appendicitis: Does Everyone Need an Operation? (subscription required)

(Mars – or the Antarctic – is hardly the only remote environment of interest; one of the studies was in Navy personnel on a submarine.)

Appendectomy is a classic teaching case on the value of ending up with a few false positives. It’s better to perform a low-complication procedure a few extra times than to have people walking out of the ER and dying when they get home. But as technology changes – in this case, antibiotic treatment options and CT-scan evaluation – it’s always good to re-evaluate even the obvious “tried and true” approaches, partly to see if there’s a better way across the board and also to address the situations where the outcome of surgery was likely to be bad. On the way, we seem to have discovered some properties of the appendix that can help us understand the environment for other GI disease – a new teaching case for this much-maligned “vestigial” organ!

We are probably right to remain suspicious, though. The appendix may well have more tricks tucked into its submucosa.

Going the Distance

I did a ton of swimming over the course of about a year after I had some trouble adjusting to running. I am still having trouble, but every time I come back to it, I have a slightly different problem, which I step back and resolve, eventually to uncover a new problem. (At this rate, by the time I can actually run regularly for more than a few months at a time, I expect to have among the most perfectly balanced physiques and flawless mechanics known to humanity.)

Swimming was a way to get deeply engaged while recovering from some of the problems I had, and San Francisco makes it easy. I am a little claustrophobic in a pool (as I discovered during the coaching sessions I did to help me develop a clean freestyle stroke). San Francisco has a park in the bay with a nearly 300m buoy line, and I probably did more than 99% of my meters there, starting right after my first coaching session by going outside to do my homework instead of trying to figure out the pool’s schedule. I got a lot of the same environmental pleasure from swimming that I got from running (much of which I did on trails within Golden Gate Park) – a slight sense of isolation makes me feel good, and the occasional sea lion sighting or near-miss with another swimmer was no big deal.


I had a mini-panic of documenting places I’d spent a lot of time as my move date approached. This isn’t a great photo of Aquatic Park, but I was running out of time.

I did a mix of wetsuit only and with fins, in part depending on distance. I found after a mile or so that it was easy to add distance from a physical point of view. I am basically an aerobic engine with cyclist legs, so this was particularly true if I had fins on – it was practically a case of “lie down and watch the miles go by.”

As I prepared to move to Baltimore, it was pretty clear I wouldn’t be able to continue swimming as conveniently and pleasantly as I could in San Francisco, and I gave a little thought to what I wanted to be sure to do. Fitocracy has in-site challenges for various distances for the triathlon sports – the longest swim distance is 10km. Challenge accepted.

I doubt I ever really believed I would swim that far. I was pushing my distances out, and I was joking with others about 10km being some kind of obvious benchmark, but I was never a fast swimmer, and the sheer time commitment posed risks such as getting so chilled I couldn’t operate my car afterward. Also, I never quite adjusted to how much more I needed to eat to support swimming – I struggled to maintain my weight as my distances climbed. (I’m not complaining exactly, but it was challenging enough to make me suspect swimming was not a long-term thing.)


Of course, as soon as I committed to move away from SF, I started seeing stuff like this all over the place! And it didn’t hurt that this was a typical view from my bike commute to work.

When I got my move date more or less nailed down, I looked at the calendar and figured out how many weeks I had to bridge the gap between my longest swim so far and 10km, which by then had firmly settled itself in my head as Important. In May, I had a little over 2 months to work up from around 6km, so there was a very real possibility I would fail. I tried to swim about twice a week – 1 short swim + 1 long one – and then I don’t remember what happened, but I got busy or distracted and ended up out the water for almost a month. When I got back in, I figured I’d try for 8km but give myself a pass if I only made it 5, and then give myself 2 more tries to hit the full 10km.

June 16 was a beautiful day, and as I approached 7km, I was happy to just stay in the water. I had “only 3k to go” – no problem, as I had just done it twice and then some.

I was ready to move.


I never did visit this place when I lived there. Maybe I can go as a proper tourist sometime.

All photos from my Instagram stream.

Happy International Women’s Day!

Perspective can be tough to get, especially on our own behavior. We know that “seeing the big picture” or “getting an aerial view” is important to deep understanding, that we need to get some distance. It’s much easier to give someone else good advice than to follow it ourselves (even when our ability to give good advice comes directly from needing it).

It’s true for group behavior, too. The conventions, the little in-jokes, the “way we’ve always done it” – these can be harmful to individuals, but if the group is homogeneous enough, the pressure to refrain from pointing it out can be just as strong as the negative experiences themselves.


From a booklet intended to help wartime supervisors bring women into the workplace, from the Records of the War Manpower Commission.

When women went to work to support the war effort, they entered an environment few of them had ever seen, supervised by people who barely recognized where they were coming from. These pages, along with 2 other spreads at the National Archives, Southeast Region, give us a look into a booklet to help those supervisors get the best work out of these mysterious new employees.


This is good advice for all managers of any employees.

The presentation has all the hallmarks of a startlingly condescending piece, but the words tell a different story. Women are cooperative, patient, teachable. It may seem ridiculous that any of those things needed to be said, especially at a time when women were expected to be agreeable, long-suffering, and obedient, but the language is certainly more respectful than those cultural expectations. And the guidelines themselves are remarkable for what they really are: just plain good advice about welcoming new employees and managing them effectively.


This IS people management.

As minority interests of all kinds receive more attention, we see over and over again that familiarity goes a long way, that seeing the old, established ways through the lens of the people who had no say in them brings harmful behavior into focus and creates the potential for a better experience for all. Men benefit just as much as women from respectful treatment in the workplace, arguably more because they still have advantages there as well!

People don’t like change, and they often can’t stand the idea that someone ‘has it easier’ because of a classification difference. Fostering the understanding that they don’t have it easier – quite the contrary – is probably a lost cause, but we don’t really need a “who has it worst” contest at work, anyway. Workplace practices that proactively and supportively resolve issues that get in the way of actually getting the work done put the emphasis where it belongs: on the work getting done.


We can do it!

 

Calm Down Bro

This is pretty good advice. Mostly.


From Skreened.

We all need a little perspective, and athletics really seems to bring out the lack of perspective in people. Usually it’s something more like Larry Bird’s “Push yourself again and again. Don’t give an inch until the final buzzer sounds,” although that quote’s unusual for its use of context: while the competition is on, you need to be, too, but there’s also an end, a time to stop pushing. For the buyers of this t-shirt, apparently the time to let it slide is whenever you’re not actually competing in a world-stage event.

Treating PE like the Olympics is almost certainly the hallmark of people who are going to make it there, though. I learn pretty easily, so it was clear to me early on that the difference between being good at something and being great at something was craft, practice, and that means drive. The greater your drive, the more you work, even when you’re already terrific, because the thing itself is the thing. We see this in many areas that cause people to ask “is it talent or practice?” It’s both. You need to do it, to inhabit it, to know every aspect of it. PE is one of thousands of dress rehearsals that will make that Olympic performance shine.

As with many things, the problem here is not a behavior but a response to that behavior. This t-shirt, whose message amounts to, “hey, crab, get back in the bucket,” has some problems bound up with its self-evident truth. But I don’t think the feeling it reflects is truly a reaction to that ultra-competitive kid. I think it’s about the PE teachers and coaches and parents who lionize aggressive, sometimes reckless competitive drive as if it is inherently valuable, thereby chiding – sometimes directly – kids who don’t have it.

I believe life is better – richer and more satisfying – when you have something that makes you feel like you’re striving for a world-class performance. Even if you never hit a truly competitive level, the IKEA effect endows your own efforts with value above the objective reality of the result. Some people will never discover anything that makes them feel that way, and some people only feel pressured by it – that’s fine, too. There’s almost 7 billion ways to live. So if you’re around kids a lot, it’s good to find ways to praise strong drive and high performance that doesn’t also trash the kids who may not have found their bliss yet, or who may prefer a less intense existence. Plus, the IKEA effect dissipates when people fail to complete a task, so don’t go actively discouraging kids who are in the midst of working on something – your downer attitude might follow them around.

People who encourage intensely competitive behavior in kids like to point out that there’s only one winner, that second place is “first loser.” I suspect the kids who are destined for the Olympics don’t really need the stick, so it’s needlessly insulting language to the kids who can plainly see this isn’t their domain, which may well sap their interest in finding a way to be engaged and excited at a different level or in a similar specialty. It privileges a few narrows ways to be successful, and it places too much emphasis on success as something one does alone. Our world is big and complex, and all the most interesting things – going to the moon, reducing the toll of childhood-preventable disease, building almost anything at a larger-than-personal scale – require groups of people, bringing different strengths and working together.

Individual achievement is inherently satisfying, an important reinforcement for continuing to put in the work that supports it. It also provides a foundation for group success, by developing the abilities that individuals will bring to group efforts in order to collaborate effectively for the majority of their lives. People are more likely to discover and develop those strengths in an environment that says “everyone is good at something – let’s find your thing” than one that just gives a few options, celebrates the #1s, and browbeats the “losers.” That all-or-nothing approach doesn’t just mislead kids on their way to learning to live in the real world, it also deprives them of a simple pleasure in community – and an important life skill: being able to share the excitement of that ultra-competitive classmate and say, “You GO! You make PE into the Olympics!”

So Meta

We tend to think of many things as modern, as if previous generations never wrestled with them, or considered them. Just as the good ol’ days really weren’t, there is nothing new under the sun.

Take this ad from the mid 1970s. (Please!) It’s easy to dismiss it immediately with a “Jeez, aim high, kiddo – and by the way, doc, you’re a jerk.” (That was the reaction at the time, too – this ad ran in New Zealand, where it was called out by a local feminist publication, Broadsheet, as among the most sexist print ads on offer.)

But there is something else going on here, something we love to congratulate ourselves for today, and that’s an implicit critique of advertising in the first place. That guy’s a random dentist, apparently doing a well-child exam. He wants to harness this girl’s good genetics and responsible dental care, which there is no reason to believe he has any responsibility for (the ad is for a consumer product bought at the drugstore), as if it represents something about his practice. (Besides hiring cheerful, attractive receptionists, as I am sure most businesses like to do.)

I love/hate this kind of advertising. I worked in advertising long enough to gravitate happily toward almost anything that subverts its premises, but sexism aside this kind of in joke makes me weary, underscoring the vacuous manipulation of the industry.

Outside the Back Door to My Building

Last fall, I moved to a part of the country that has a so-called real winter, after living on the West Coast for my entire remembered life. As luck – or something – would have it, I happened to move right before the snowiest winter in 5 years, approaching the snowiness of a 2009 season dubbed Snowmageddon.

My mother grew up a couple hundred miles north of here, and she’s been horrified on my behalf by the weather reports. I have appropriate clothing and have mostly been working from home – and I have a comfortable apartment – so I haven’t had (m)any complaints. Also, the local authorities are good at road clearing.

And when you’re not struggling with heat or transportation, even a somewhat alarming clowder of icicles right above the back door is rather beautiful.

Thing-a-day 28: Health at Different Sizes

 


Photo by Martha Holmes — Time & Life Pictures/Getty Images
Dorothy Bradley, photographed for LIFE magazine article on obesity, works out in 1949.
—From Obesity: Photos From the Early Fight Against a Health Crisis, 1954

LIFE recently published a series of photos taken during the reporting of a story it published in 1954, about the problem of obesity. It features Dorothy Bradley, who embarked on a program of losing more than 50 pounds using a combination of changes in eating habits and getting more exercise. The photos show her in the gym in sweats, in a swimsuit preparing to swim, trying on dresses, sitting at a diner counter, wedging herself through a turnstile. And finally on a dance floor in a ballgown showing off her newly pared-down waist.

I love this photo in particular. We can clearly see a strong body, and an essentially aesthetic silhouette. Dorothy probably had many advantages over people who embark on this journey today at the same starting weight she did: she probably had more activity built into her day getting to and from work, and fewer labor-saving devices at work and at home. Although she may have eaten carbohydrate- and fat-heavy foods, they were less processed than typical foods in today’s environment. Another photo shows her with a slim, grim-faced nutritionist, behind whom is a poster listing “MUST FOODS – EAT DAILY” (milk, meat/fish, citrus, other fruit, vegetables, grains, fats – one wonders if they were meant to be eaten in that order). We learn that she was pursuing nursing (and did so successfully). Yet, with all these environmental advantages, and her explicit interest in health and healthcare, she had to lose the majority of this weight twice before she kept it off.

LIFE meant to show that the obesity epidemic is not new, but I think these photos show us something important about how unhelpful our messages about weight and health have become. The buried lede is exercise. One of the captions reads, “In gym in New York sweat-suited Dorothy finds workout did not by itself remove pounds but did help avoid flabbiness as she lost weight dieting.” Fitness experts love to tell people that “exercise doesn’t work,” but that caption and the photo above tell a different story. It may well be that “abs are made in the kitchen,” but nobody needs visible, ripped abs. People need stable blood sugar, a good blood lipid profile, a good red blood cell count, enough body fat to support cell functions and aid in recovery but not so much that organs lose function by being packed in it. And those goals are better supported by regular, low- and moderate-intensity exercise than by a specific diet – and the exercise can stabilize mood and lift the energy level as well.

One notable thing about these photos is Bradley’s relative isolation. We certainly don’t see any shouting trainers. We see Bradley wrestling with her body image out in the world, but mainly we see her alone with her exercise and tape measure. I find these to be surprisingly positive images. This is doable. It helps to have some consultation, which we see with the nutritionist, and it helps to know why you’re doing this, which we see with others around her, but ultimately the work itself is you alone – it’s you with your food choices and with your exercise. And the path may not be strictly linear, but you can make it if you take the long view.

Among the least-helpful cultural baggage surrounding obesity is persistent messaging that focuses on looks. Obesity is a look onto which people feel free to project assumptions of laziness, incompetence, ignorance. We still have a way to go in understanding how body fat, conditioning, and nutrition combine to support healthy outcomes, but research results are trickling in, suggesting that you definitely can be too thin (although for good health outcomes in the US, it still helps to be rich). High-protein eaters with heavy exercise schedules are helping to challenge claims about saturated fat dating back to the 1950s, and gut flora libraries are being assembled and coordinated with food records to add more pieces to the food-and-health puzzle. I hope that this better information environment can help us pay more attention to what we’re really trying to affect when we talk about addressing the obesity epidemic: bad health outcomes, early mortality, lost productivity, rising healthcare costs. And although we still need cheap, simple methods for tracking, like weight scales and tape measures, here’s hoping we can see them for what they are – approximate tools instead of final arbiters.