Positive Doctor Visit

June 9, 2008 at 10:57 am (medical care)

I went to the doctor the other day, something I’ve been putting off for a long time now. I’ve had such appalling medical care, most of my life. Here’s an example: your tonsils aren’t made of fat. They aren’t fatty tissue. You don’t gain weight in your tonsils. Yet when I complained to a doctor about having tonsils so large they touched and made swallowing, eating, pill taking, and breathing difficult, I was advised to lose weight. Uh… yeah. Helpful. I got them removed ten years later while seeing a different doctor and my health improved drastically.

I’m short and I’m fat, and the go-to assumption among medical folks, including dentists, is that I have high blood pressure, high cholesterol, and diabetes. Which I don’t. But they always ask me, and then push for me to admit that I have these problems. It’s stressful, because I’m being accused of lying about my health.

So I went to the doctor and they had a large-sized blood pressure cuff right there and used it no problem. My blood pressure? Totally normal. My pulse? Really fast. They asked if I have heart palpitations. (I said no, but I’ve also passed out in the shower once and almost did again last weekend, but that might have been stress related. Might not have been, too. I’ll mention it at the follow up in a few weeks.) They had to give me  a DPT booster, and have special longer needles for fat patients, so the vaccine actually gets into the muscle. I never knew this was an issue, and have never had a longer needle used on me before. The doctor offered me two different sized hospital gowns, one of which was snug and the other was really big but more comfy than the small one.

I have GERD. The doctor did NOT push losing weight. He did not assume I had cholesterol problems or diabetes. He ordered blood work and asked when I’d eaten. I answered, about an hour ago. He said it didn’t sound ilke I was diabetic at all, so blood sugar shouldn’t be a problem and the time of eating shouldn’t matter. He said he was concerned about my thyroid and wanted to focus on that. He did NOT ask about my eating habits, he did ask about my activity level and was fine when I said I walked regularly. He did not suggest weight loss as a solution for my problems, or that my weight was making me unhealthy.

It was, in general, a positive and respectful experience and a completet 180 from my usual medical experiences. I’m surprised and pleased and less nervous about seeing the gyne and derm. I am still in a high state of anxiety about the dentist, but that’s almost completely unrelated to my fat.

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Every Day Fat

June 9, 2008 at 10:48 am (fat, life)

I was walking home the other day when a man in a car pulled up at a stop sign, rolled down his window, leaned out, and screamed obscenities at me. I was walking on a sidewalk on the other side of the street. Among the epitaphs? I’m a fat fucking cow and a land whale. Also, this stranger thinks I should kill myself. Huh. I didn’t know that my being fat was so offensive that a complete stranger felt the need to advise suicide. Oh well, what do I know? I’m not human, I’m an animal… a cow, a whale. I’m so incredibly immense that my only real option is death at my own hands, I guess.

Fuck that noise.

I’m wearing a dress today that has no sleeves. I’m showing off my ham-like upper arms. I don’t usually wear sleeveless stuff less because of my giant beefy arms, but because my armpits are scarred up and I don’t shave my pits regularly because of skin problems. But it’s hot today so fuck it. Everyone gets to see my cheese-pale arms. And possibly my armpits, if they look closely. I don’t really care.

Actually, I do care. I have a short sleeved cardigan with me that I intend to wear while walking home, even though it’s supposed to be another hot day. I am going to wear a sweater in 90 degree weather because the alternative is showing strangers my big fat arms. And I really don’t like when people pull over and verbally abuse me for committing the intense sin of being alive, of existing, of taking up space. So: a sweater that covers my arms, in 90 degree heat.

Once again, most of the fat-related problems I have aren’t due to me being fat. They are due to other people reacting to my fat.

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Just THINK about what you eat!

May 13, 2008 at 4:47 pm (binging, diets, disordered eating, media)

This lovely quote came from the Wall Street Journal:

“Most people don’t think about what they’re eating — they’re focusing on the next bite,” says Sasha Loring, a psychotherapist at Duke Integrative Medicine, part of Duke University Health System here. “I’ve worked with lots of obese people — you’d think they’d enjoy food. But a lot of them say they haven’t really tasted what they’ve been shoveling down for years.”

So is it most people who don’t think about what they’re eating, or just obese people? Also, why would obese people enjoy food more than non obese people? Are thin people simply unable to enjoy food, or does this psychotherapist simply buy into the notion that all fat people are fat because they overeat and no thin people over eat? Also, note the degrading, insulting term “shoveling down” in reference to eating habits of OMG TEH OBESE. They don’t eat food. They “shovel down” food. You know. Like shoveling slop from a barrel into a pig trough.

What’s different about mindful eating is the paradoxical concept that eating just a few mouthfuls, and savoring the experience, can be far more satisfying than eating an entire cake mindlessly.

Once again, LOL FAT PEOPLE EAT CAKES LOL. I weigh 280 pounds and have never “eaten an entire cake mindlessly.” Even when binging, which is abnormal and unhealthy behavior that will not be magically cured simply by “paying attention to what you eat,” I’ve never “eaten an entire cake.” But, you know, all fat people are fat because they eat cakes constantly. If they’d just stop SHOVELLING FOOD INTO THEIR GAPING MAWS, they’d be thin. And healthy. And fabulous. And human.

One key aspect is to approach food nonjudgmentally. Many people bring a host of negative emotions to the table — from guilt about blowing a diet to childhood fears of deprivation or wastefulness. “I joke with my clients that if I could put a microphone in their heads and broadcast what they’re saying to themselves when they eat, the FCC would have to bleep it out,” says Megrette Fletcher, executive director of the Center for Mindful Eating, a Web-based forum for health-care professionals.
So, does that nonjudgemental approach to food include accusing people of “shovelling down” food and “eating entire cakes”? Because that seems kind of, you  know, judgemental to me.
Chronic dieters in particular have trouble recognizing their internal cues, says Jean Kristeller, a psychologist at Indiana State, who pioneered mindful eating in the 1990s. “Diets set up rules around food and disconnect people even further from their own experiences of hunger and satiety and fullness,” she says.
Oh, hey, but diets totally work and if you’re fat you should totally diet so that you can be skinny. Even though it fucks up your internal cues and makes you unable to tell if you’re hungry or full or what.
“I don’t think about food anymore. It’s totally out of my mind,” says Mary Ann Power, age 50, of Pittsboro, N.C., a lifelong dieter who thinks she’s lost eight or 10 pounds in two weeks since learning the practice at Duke. “I think you could put a piece of chocolate cake in front of my nose right now, and it wouldn’t tempt me. Before, I could eat three pieces.”
I frequently have chocolate cake or other goodies around me without diving face first into them. I currently have a Vosges Gianduja Bar on my desk that’s been here for two weeks. I love this chocolate bar, but haven’t been hungry for it. If I want it, I can have it, but I haven’t wanted it. Sorry, this fatty isn’t really in the habit of “shovelling down” available food. I don’t need to, because I don’t deny myself and categorize food into “good” and “bad” subsets. It’s just food. I mean, you know, good on her that she no longer feels the urge to binge on chocolate cake. But still.

One of the most frustrating thing about this Hot New Practice!!!! is that it has its roots in Buddhist medidation. It’s like aping Ramadan’s fasting rules or giving up eating for Lent for the vain purposes of losing weight. It’s cheapening a religious practice, removing all the religion and spirituality, and using it solely for vain, earthly purposes. And that is FOUL.

I really don’t see Buddha usind Mindful Eating as a weight loss measure. Do you?

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“Death is the outcome we’re most concerned about avoiding.”

April 30, 2008 at 1:00 am (diets, media, weight loss)

Inside Drugmakers’ War on Fat

Bradbury watched a live simulcast as an FDA advisory panel grilled Sanofi executives over the memory loss, dizziness, depression, and other side effects reported by people who took Acomplia in clinical trials. Most worrisome, at least four people on the drug committed suicide.

The FDA demanded that Amylin explain why some patients in the pramlintide trials suffered hypoglycemia, or dangerously low blood sugar.

Problems with weight-loss drugs date from the 1950s, when doctors began dosing overweight patients with Dexedrine, a form of speed that left people strung out and sometimes addicted.

But when patients began suffering damaged heart valves, fen-phen was hastily pulled from the market.

With Sanofi’s Acomplia, the major concern was suicide. One patient who took his life after using Acomplia was a 36-year-old man with no history of depression; another was a 77-year-old man who had been treated for depression 30 years earlier.

Phentermine was never implicated in the heart-valve issues that caused fen-phen to be recalled, and it remained on the market as a solo treatment. But it can make people so jumpy they feel like crawling out of their skin.

Topiramate, an epilepsy treatment that J&J tried to repurpose as an obesity cure, has an even more disturbing record: At the high doses required to promote substantial weight loss, many patients lost their ability to think straight. That’s because topiramate slows the rapid firing of neurons in the brain—a dulling effect that’s wonderful for controlling seizures but that can turn non-epileptics into bumbling dimwits, doctors say.

After it released a small 12-week study, press reports focused on a disturbing revelation: About 30% of patients on the drug reported psychiatric side effects such as depression, vs. 18% who were taking the placebo. Amatruda says the side effects were clearly worse in the patients who took the highest doses of the drug, and that the company has decided not to seek FDA approval for the higher doses.

Hey, are you fat? Well, modern medicine has a solution for you. Maybe. If you’re cool with shitting yourself, being unable to think, developing problems with your heart valve, or killing yourself, that is.

The latest obesity research is centering on an increasingly popular scientific premise: The human mind is all but hard-wired to hold the body at a certain weight. When people take a drug that helps them shed pounds, or even when they lose weight with exercise, an intricate tangle of brain signals kicks in to tell the body it’s in danger. Metabolism slows to help the body preserve itself, and hunger intensifies. Most scientists have come to believe that obesity is not a disease of gluttony so much as it is an unfortunate roll of the genetic dice, made harder to fight in Western nations by the growing availability of cheap food. “Some people are preordained to have a higher body weight than others. It’s normal’ for them,” says Rudy Leibel, a professor and obesity researcher at Columbia University. That may be why most people who slim down with drugs plateau after they lose just 5% to 8% of their weight: When a drug blocks one of the brain’s appetite pathways, another goes into overdrive to tell the body to find food, right now.

Or you could just, you know, be fat. The way your body is meant to be. The way you were made to be.

But there’s not a lot of money in people just being fat, is there?

These quotes are from the same article. In one breath they talk about how dangerous– how deadly, even– diet drugs are. And in the next breath they quote a scientist talking about how some humans are just fat and that’s the way they are.

Wake up! Diet drugs, diets, pills, concoctions, shakes, prepared meals, calorie counting books, diet websites, diet books… they don’t exist because they’re healthy, they exist because they make money. You can be happy and fat. You can be healthy and fat. In fact, it looks like you’re more likely to be happy and healthy and alive if you’re fat than you will be if you take diet drugs.

Stop buying into the diet machine. You don’t benefit from it. You just line the pockets of somebody else.

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Cruel and unusual?

April 29, 2008 at 9:57 am (diets, media, weight loss)

Part of the penal code of the USA outlaws cruel and unusual punishment. Does that include starvation? If a man in jail for murder drops 25% of his body weight in only 8 months, is that cruel and unusual punishment?

Broderick Lloyd Laswell has lost over 100 pounds in under a year, and has filed a lawsuit against Benton County Jail claiming that he and other inmates aren’t getting fed enough, and claiming also that the inmates should be fed hot food, instead of cold food only, which has been policy for years. Meals are provided by Aramark Correctional Institution Services and, assuming that all food in the meal is eaten, inmates should be taking in about 3000 calories a day. If that seems like a lot, bear in mind that the average calorie requirement for a man is 2700 calories a day.

“On several occasions I have started to do some exercising and my vision went blurry and I felt like I was going to pass out,” Laswell wrote in his complaint. “About an hour after each meal my stomach starts to hurt and growl. I feel hungry again.”

Laswell claims he’s lost about a half-pound a day.

“If we are in a small pod all day (and) do next to nothing for physical exercise, we should not lose weight,” according to Laswell. “The only reason we lost weight in here is because we are literally being starved to death.”

http://www2.arkansasonline.com/news/2008/apr/27/murder-case-defendant-complains-about-jail-diet-re/

Let me state this again.

An otherwise healthy man has lost over one hundred pounds in eight months.

An otherwise healthy man has lost 25% of his body mass in eight months.

But, hey, you know, at least he is less of a fatty than he was, right? He should be greatful that any time he tries to do any physical activity he gets dizzy and almost passes out. It means the enforced starvation diet is working! A lack of physical activity is totally healthy as long as he keeps shedding those extra pounds.

 

 

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Bad Advice: Binging on the weekend

April 28, 2008 at 3:44 pm (advice, binging, diets, disordered eating)

I want to start doing a theme where I take advice column questions and answer the answers. Today’s question comes from About.com
Weekend Diet Traps

I eat a healthy diet Monday through Friday, but on the weekends, it’s no holds barred. How do I bring in the reins?
…Your mindless weekend binge just ruined an entire week of healthy eating. Then the guilt sets in. You get back to your routine diet on Monday, feeling bad and vowing to eat right next weekend. But then Friday comes around and the whole cycle starts all over again. …

Your mindless weekend binge ruining an entire week of healthy eating is one way of looking at it. However, what if you aren’t “being bad”? What if your body is desperately trying to make up the calories you’ve been denying it all week by being “good”?

Most of the “tips” in the article have to do with face-stuffing and offer helpful suggestions like “don’t keep food in the house” (ok, I’m exagerating slightly) and “don’t order vast amounts of food at restaurants… if you do, don’t eat it all.” They push fruits and veggies, under the asumption that you’re not eating them at home, I guess. And then there’s the slide into disordered territory. Log everything you eat. Keep track of every calorie consumed, every bite you take. Hungry? Take a walk to distract yourself! You’ll burn calories, too! Want one thing? Have another! Have some fruit. It’s mostly water and fiber.

Nowhere does it address the actual problem, which is a repeat pattern of binge behavior. Nowhere do they ask “are you really binging, or just not dieting? And if you are binging, what’s the reason behind it? What’s causing it? What aren’t you getting that you’re trying to replace with food?

I also don’t like the assumption that a “healthy” diet is one that’s bad or boring. It’s very possible to eat healthily and enjoy your food. In fact, that should be the default… enjoyment of food. Scandalous, I know. But what happens when you don’t enjoy your food during the week? You stick your face in a pie on the weekend. Yeah. That’s healthy.

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Stop shoving food in your mouth and you’ll get thin!

April 18, 2008 at 11:32 am (media, weight loss) (, , , )

I’m getting really fed up with advertising recently, specifically advertising targetting fat people.

Subway’s got full page ads in magazines about how going through life “supersized” doesn’t make for a good childhood, or having a “supersized” childhood is no way to have a life or something like that. I was unable to find this ad on Subway’s website, or mentioned on line, but I have to say something here: I was a fat kid, and my fat didn’t cause my problems. Other peoples’ reactions to my fat did. I’m a fat adult and, again, MY FAT is not the problem. MY SIZE is not the problem. MY BODY is not the problem. It’s OTHER PEOPLE TREATING ME LIKE CRAP that’s the problem. It’s OTHER PEOPLE TREATING ME AS LESS THAN HUMAN that is the problem. Further, it echoes the Animal House quote “Fat, drunk, and stupid is no way to go through life.”  So, you know, thanks Subway. You think my life is worth less than a thin life. That’s good to know. Now I have another reason besides the incredible bland taste of your sandwiches and poor service in general to avoid your stores. Thanks!

There’s television commercials where people stumble across discarded lumps of pale lard. These are chunks of peoples’ bodies (double chin, back fat) that they “lose” because they “snack on veggies and fruit while on vacation!!!!” or “get the small popcorn instead of the large at movie theaters!!!” Hear that, fatties? If you’d just stop shoving food into your gaping maws every possible second, you’ll magicaly become less fat! Chunks of you will drop off and fall onto the floor for stylish, slender people to find and marvel at. Do you have a double chin the size of a pregnant woman’s stomach? Well, fret not! If you simply snack on veggies and fruits while on vacation, those pounds will melt away, since obviously you never consume any veggies or fruits whatsoever and probably just shovel lard-coated Big Macs into your mouth non stop. And, you know, losing large amounts of weight is so incredibly easy that you can do so simply by making small changes for a week or so while on vacation. it’s just that simple!

Remember: your body size is wrong, and you’re inferior for having it. If you can’t change your body size by doing small, simple things then you need to mutilate a major organ in your body or else starve yourself or perhaps compulsively exercise. If that doesn’t work, it’s because you’re lying and secretly gorging on breath  mints and dough nuts. But above all, your body size is WRONG and you are BAD for having the body you do.

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The Diet Mindset

April 8, 2008 at 11:49 am (diets, disordered eating, weight loss) (, , , )

It’s pervasive, this idea that if one simply limits one’s calories below what they need to survive, one’s excess weight will melt away like so much ice cream in the hot sun. Despite studies that have shown that people burn calories differently when they have plenty to eat versus when they have little to eat, and despite studies that have shown that biologicaly fat people and thin people burn calories at a different rate, most non-fat-friendly people who talk about THE OBESITY EPIDEMIC lead off with the assumption that fat is a choice, and fat people could all be thin if they’d only eat less and move more… despite the failure rate of diets, and despite the fact that most fat people have been on diets and failed, and despite the fact that many many many articles talk about “the dangers of yo yo dieting” in the same paragraph they talk about yet another low calorie starvation fest.

I know my body. I’ve lived in it for a long time, and started listening to it actively recently. I know for a fact that I can limit calories to starvation levels while doing intense aerobic exercise for many hours a day and still not lose weight. But the other day while changing into pajamas and thinking about whether or not I wanted to have some ice cream, that little niggling voice in the back of my head whispered that if I’d just skip the ice cream my clothes would fit that much better. And maybe I should just have a salad for dinner, or skip it entirely. I have been losing weight after all. If I just take control and limit my calories a bit, I’ll lose even more weight, even faster.

This, despite the fact that I’m losing weight at a time when I’ve eaten more calories than I have in years. I’m eating more food over the course of the day than I usually do because I’m not restricting what I eat, I’m not eating what I “should” eat. I’m eating enough to be healthy and have energy and to keep me alive, and my body’s responding by stopping it’s OMG FAMINE HOARD HOARD HOARD freak out and letting go of the excess fat I have… the fat that truely is excess, and which has me at a higher point of my body’s natural set point. I know what’s healthy for me, what’s good for me. Yet even knowing that, I still feel the urge sometimes to act in unhealthy, destructive ways; to engage in disordered eating and compulsive behavior again.

And that’s not right and that’s not good and that’s not healthy, and that’s the diet mindset that grips this country.

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Weight Loss

April 2, 2008 at 1:00 am (diets, disordered eating, weight loss) (, , )

I haven’t been doing any extra excercise lately, or conciously restricting my caloric intake. I have, however, been pretty sick, to the point of not eating. But when well enough to eat, I’ve been eating pretty fatty things– in large part a response to my enforced fasting, I think, and the fact that my body is trying very, very hard to recover and get well and needs to burn calories to do so. Despite that, I’ve been losing weight over the past few months.

I first noticed it, as I always do, in my breasts. I’ve gone down a cup size. And now my pants are too large on me as well, and some shirts with very snug arms now fit a bit better in the shoulder/upper arm area. When I look in the mirror I look different. Shirts on hang on me differently. I don’t know what I weigh. I don’t own a scale, and the few times I’ve stepped on one, out of curiousity, in some friend’s or family member’s bathroom, the needle has burried itself in the “lolfattylol” range of over 250 pounds. Just… thunk.

If I mention my weight loss to most people they congratulate me. “You must be so proud,” they say. But I’m not proud. I’m not doing anything to lose weight, and even if I were, why should I be proud of the size I am? How is that an important thing?

What I am, however, is worried. I’m something of a hypochondriac, so I lose weight without meaning to and my brain is all “OMG cancer! OMG thyroid problems! OMG tape worm! OMG YOU WILL DIE.”

I spoke with another friend of mine, who is also fat and who also grapples with positive self image, FA, HAES, and intuitive eating. She asked me if I started losing weight after I started eating more intuitively and yes, that’s when it started. When I finally let go of a lot of my hangups with food and started listening to my body, I started losing weight. I’ve been feeling healthier for a while now, eating a more balanced diet. I doubt I’ll loose MUCH weight… just get back to a lower point in my body’s natural range, which is still fat. But people tell me I’m looking better, that I must be proud. After all, I’m losing weight! Isn’t that fabulous?

I was sitting in the lunch room at work while a co-worker talked excitedly about finally fitting back into a pair of pants she hadn’t worn for sixteen years. Which means that she hauled these pants (and other articles of clothing) around with her every time she moved for sixteen years. For sixteen years, those clothes have been taking up closet, shelf, and drawer space. Instead of buying clothes that fit and look good on her, she’s been maintaining a shrine to clothes she can’t wear, for over a decade and a half. They’re nice pants, don’t get me wrong, but not worth wearing around your neck for sixteen years. She took a break from marveling over the new shape of her butt and thighs to congratulate another coworker on her recent weight loss. The other coworker tried to deflect the congratulations by saying she’d been really sick. “But you look so great! So thin!” “Yeah, I was really sick. I almost went to the hospital. It was awful.” “You must have dropped two pants sizes! You look so good!” “Uh… I couldn’t stop puking. Seriously. I thought I would die. I was so incredibly dehydrated. I burst all the blood vessels in my eye balls.” “Really really great! You’re so slender now! Your clothes are just hanging off of you!”

Because being thin is always healthier than being fat. Always.

I’m so glad I found FA.

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Medical Care

March 31, 2008 at 12:25 pm (medical care) (, )

When I was three, I got sick. I never got better. My nose ran all the time, I got cold after cold and ear infection after ear infection and strep throat after strep throat. My dentists and orthodontists would comment on how large my tonsils were, even when I wasn’t actively ill. Taking pills was an ordeal because my tonsils, so large they touched, made swallowing anything but especially hard and sticky pills, extra hard. By the time I was a teenager, I had hearing loss in one ear from built up scar tissue, consistantly had difficulty breathing, and suffered from bronchitis 2-3 times a year.

I still had my tonsils.

I still had my tonsils because my pediatrician took a look at them, after writing yet another prescription for pennicilin, and told my mom that “we don’t do tonsilectomies anymore” and then offered that if I lost weight I might have better health.

 Because tonsils, you know, are nothing more than sacks of fat. When a person gains weight, it’s routine for their tonsils to get fat as well.

Oddly enough, I had a different doctor as an adult. The first time she saw me she pinpointed my tonsils as a problem, scolded my dad (who’d driven me and was in the waiting room) for not getting them taken out earlier, and arranged for them to be removed in about a month’s time. That was eight years ago, and I’ve had bronchitis one time since then.

I suffered with constant ill health, exhaustion, hearing loss, and infection after infection because a doctor was unwilling to look past my fat to find the root cause of the problem, even when the problem (and solution!) was an incredibly obvious one.

I had bronchitis a month ago and saw a nurse practitioner about it. She listened to my lungs and asked me if I’d been screened for asthma. I said no, but now that I had insurance I was going to… I just needed to find a doctor and make an appointment. I didn’t say that I’d never been screened before because as a minor my complaints about shortness of breath were consistantly dismissed as me being out of shape, despite the fact that I danced competitively, had allergies, had chronic bronchitis, and had a parent with asthma. In other words, I was active, and had three red flags for asthma. But, you know, I was also fat and apparently fat trumps everything else as cause of illness and pain.

 I hear a lot of talk in the “everybody knows” vein of how fat people are a scourge on humanity because they cost so much more in medical bills. But I can guarandamntee you that if I’d had my tonsils out as a kid, it would have cost less and would have taken less of a toll on me, personally (a few days recovery versus three weeks recovery for the actual surgery, not to mention all the illnesses I wouldn’t have had and gotten treated). If I’d had my asthma treated and controlled in a timely manner I’d be in much better physical shape now, both because I’d be more active and because I’d be less suspectible to colds and respitory illness. In other words, my fat has cost me more money  not because fat is unhealthy, but because I’ve received shitty medical care that has wound up costing me extra money because I have gone untreated for some pretty basic and obvious things. So I guess fat people don’t cost extra money so much as incompetent jerk-ass doctors cost patients and insurance companies more money when they fail to treat their patients’ complaints.

But that doesn’t make a good soundbite, I guess.

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