27 new of 41 responses total.
I will agree with Mary that fat people simply do not get as good of medical care as thin people for various reasons from prejudice in the health care community against fat to the technology and techniques being generally focused on people of more normal weights. As the average weight is increasing though, I suspect that the technology will catch up and there will be better machines for diagnosis and better treatments. I also hope that once people start talking about fat issues some of the negative feelings about fat people and just fat in general will go away which would certainly address the issues with medical professionals and any care differentials that they might give. But as usual, I will invite anyone to answer a question: 1. What is the risk of being 100 lbs overweight? Is it as bad as tobacco where 50% of smokers will have smoking related illnesses that will shorten their lives by an average of 12 years? The best answer I have gotten is that being 100 lbs overweight for a woman doubles the chances of death at any given time compared to a normal weight woman. Being 10 lbs underweight is even worse. But that statistic has lots of flaws because it doesnt control for anything. It counts all deaths for any reason and doesnt even mention what the risks of death are in the first place. So it is double of WHAT? I could go on but I wont. I have also heard that a morbidly obese woman's chances of dying are about the same as a normal weight man's chances of dying. Anyways, my feelings generally are that I try not to judge other people's choices about what they do to their body or what they eat even when I dont agree with them. I think that Americans get really moral about food and bodies and such and I just dont like that. I have nothing against anyone's decision to go on a diet or to lose weight. Well, Ok, I'll admit that whenever someone tells me they are going on a diet, I think that it is a shame because they are almost certain to fail and then will feel bad and I will admit that I have to bite my tongue so I dont point that out to them. I am always happy when folks do lose weight and keep it off if that is what they wanted to do. I also dont like that "health" is often an excuse used to discriminate against fat people. That statistic I have heard that a morbidly obese woman has the same chance of dying as a normal weight man really brought a lot of the fat prejudice home to me. Because no one is saying that men need to be become women for their health in the same way that people insist that fat people become thin people. If health were really the issue, then men should be treated the same as fat people. I dont expect to see a special male-to-female sex change hospital to open in our area any time soon in the way that an entire hospital in Ypsi is devoted to bariatric surgery. And fwiw, I am not happy being at my weight either. But it isnt for health reasons. It is pretty for the same reason that I am glad I am not a Mexican illegal alien or a black person or Asian or gay. It is because being in a class of people who are discriminated against and judged all the time really sucks. It is stressful.
I am not happy when I'm heavier not because of health reasons, but it's because I just don't feel good when I'm bigger and I am more depressed (though I'm not really a depressed person, I can tell a difference in hind-sight of how I was really kind of depressed). I just feel better. I strive to stay thinner because of health, though. I maybe wrong, but it is my feeling that I am much healthier now than I was 120lbs ago. If I am wrong, then I don't really care, because I am happier this way anyway. I do agree that fat people totally get discriminated against, because I have experienced it first hand.
resp:15 One thing I think you've totally overlooked in Mary's post was not that the technology was the problem in medical care- but the obese person's body! A seriously obese person simply doesn't heal wounds as well as someone of a smaller size. That has nothing to do with medical technology and everything to do with being obese. Sure there are medical technologies that could be improved- I guess- like stronger ultrasounds so that doctors could get a clearer image underneath all the fat layers. But the question I have is- at what cost? Would the stronger ultrasound waves have more negative, damaging effects? It's good that you hold your tongue when someone tells you they're going on a diet- because adding negativity only makes the situation worse. There's nothing as bad as telling someone you want to try something only to have them tell you not to bother because you'll fail. You know what- maybe they will join that 5% that actually manages to lose weight and maintain it. It sounds like there are at least a couple people on this board that have managed to lose weight and maintain it for years. I've stated many times that I want to lose weight- the reason is that that I will be healthier. Can you currently run up a couple flights of stairs without being out of breath? I'm currently at the heaviest I've ever been (thanks in part to metabolism changes after I quit smoking), although I'm no where near 300 lbs, and what I don't like is that certain things ARE harder. Sitting on the floor and getting up is still doable, but it used to be easier. My knees are also starting to complain, and would cause problems if I weighed more than I do. These things just aren't good health-wise, even if my cholesterol is at good levels and my blood preassure is fabulous. You mentioned the health risks with smoking- and there is one main comonality between obesity and smoking- both are a choice.
resp:16 WEll, I always say that if what you are doing makes you happy, then it doesnt matter. This is why I bite my tongue when people talk to me about homeopathic remedies that have no basis in science. IF it makes them feel better and healthier than more power to them. I mean what you are doing is making you feel good, Jeanne. So there is NOTHING wrong with that. And for all I know, for you, being thinner is healthier. Everyone is different and everyone needs to make their own choices. Part of the issue is that certain behaviors which are healthy cause people to lose weight which puts them at the lower end of their natural range. But is the weight loss itself that is healthy or is it the getting off the couch which is healthy? No one really knows for sure. The only study I have seen that corrects for things like activity levels showed that fat active people were more healthy than thin inactive people. But of course we could go around and around on this issue. Unlike the tobacco issue or global warming, there is no scientific concensious about the effects of obesity. There are studies that show it is bad, there are studies that show only really extreme obesity is bad, there are studies that show being between 1-100 lbs overweight is GOOD, etc. None of the media reporting on the subject seems to give meaningful statistics. Usually they say things like "Obesity increases risk of breast cancer" without mentioning what the increased risk is. Anyways, one of the things I find interesting is a debate going on in the "fat blogosphere" about how to handle the health issue. There are people who want to get the message out that being fat is usually not unhealthy (i.e. fat is a state of being, behaviors are healthy or unhealthy) and that you cant tell a person's health by their weight. And there are those people who say that the whole health issue is a way for anti-fat people to frame the arguement in terms of a different form of discrimination and moral judgement (healthy vs. unhealthy) and this is wrong because even if a fat person has bad behaviors and unheathly habits, they still deserve the same dignity and treatment as other people in our society. Anyways, one of my favorite bloggers has a post about just this issue which I ran across last night. She says things a lot better than I can http://kateharding.net/but-dont-you-realize-fat-is-unhealthy/ resp:17 Ok, I will accept that fat people dont heal quite as well as thin people. But in the grand scheme of things, that isnt a big risk. I will also accept that fat people are more likely to have certain joint problems later in life (although less likely to have them than athletes). But I imagine that surgical techniques could be developed to make healing go better for fat people and I also imagine that medical technology can help with a lot of the joint problems people are likely to encounter. I do, btw, understand the economics of it all. Such a small percentage of people are over a 100lbs overweight that it probably wouldnt be in the best interests of medicine to focus on fat people. As our population gets fatter though, I expect more resources will be devoted to such things. I know it is good that I bite my tongue when people tell me they are going on a diet. For all I know they might be one of the 5% who actually lose weight and keep it off. They might even be like Jeanne who has lost a LOT of weight and kept it off for years and years. Of course it is possible for people to lose weight. I wish that people would give me the same courtesy when I talk about my decision NOT to try to lose weight. It is a rational decision. I sometimes really start to feel some of the fat community cliches in situations like that. Like the one about how being fat and happy with one's body is a radical act. It drives people NUTS. seriously. If I say: "I like my body. It is healthy. I dont think I am ugly" and so on, there are always tons of people who go out of their way to tell me I am wrong WRONG wrong. Obesity is not a choice though. Obesity is a state of being. Smoking is a behavior. They are quite different. I kind of like thinking of obesity like gender. A person can change their gender if they wish. But there simply isnt the social pressure to do it. Why not? Because we see gender as a state of being and not a choice. Technically, though it IS a choice. Just like obesity is a choice. Actually, I might even theorize that it is easier to change gender than it is to change body mass. As for my personal health issues. Well, no. I can run up two flights of stairs. Mostly that is due to a couple of injuries though. I dont get winded when I climb stairs. My knees hurt too but again, that seems more related to injury than weight or at least I think so because my knees have been getting better. I might have healed more quickly if I were thinner I suppose. None of that matters. What it would take for *me* to become a thin person is not healthy for *me*. What you do to become thinner may or may not be healthy for *you*
Oh yeah, and btw, Anne...congratulations on quitting smoking. Most people who quit smoking gain weight and even though they do, they are still generally healthier than people who continue to smoke.
Just to make sure something gets recognized first off- I really don't think you're at ALL ugly. Okay? :) I don't think weight makes a person ugly. I do think being overweight is unhealthy- but it doesn't make a person ugly. As for the risks with healing- I must disagree. When you heal more slowly- and that includes the way your skin heals from cuts/incisions- you seriously leave the body open to infection. And a lot more visits to the doctor's office to check on the wound, and lots on bandaging, etc. To be honest one of the problems I have with "diets" is their suggestions to eat 'lite' foods and what not- and quite frankly, I don't trust all those chemicals. Butter may not have the right level of calories- but at least I have a much better idea of what's in it. So yes, hubby and I use butter in our cooking. Plus I just think it tastes better. My theory is all about moderation. I would rather eat smaller portions of good foods rather than perhaps larger portions with chemicals I can't pronounce. ;) Overeating is a problem for many people- which is why I'm trying to be more aware of portion size AND get this 'must clean off my plate' idea out of my head. As for activities- I do want to be more active, be able to take the dog for long walks, maybe even run a little. These things should not be impossible, or terribly difficult.
If you dont think fat is ugly, you are probably different than most people. And good for you! Personally, I have found that changing my own personal views about what is beautiful has not only helped with my own self esteem but has helped me really appreciate other people. If the only health risk actually caused by obesity is slowness in healing after surgery, that really isnt much of a risk. It certainly is something I can live with. I am conceding that point for the sake of arguement mostly because it really doesnt matter. Saying that there are health risks associated with obesity is very much like saying that there are health risks associated with any other human state of being. There are health risks associated with being black, with being poor, with being less educated, with being male, etc. It is only in the case of obesity where society has decided (without much evidence, btw) that losing weight and changing the state of being will improve health. As it happens. I think moderation is a good thing. I have been working on not overeating for a while now as I have discussed here before. I have had some limited success in that department in that I seem to have a more normalized outlook on food than I did before. I even leave food on my plate sometimes! I agree with you wholeheartedly that overeating is a problem for many people. But overeating is a behavior. Being more active is a behavior. Obesity is a state of being. There are many normal weight people who overeat and dont exercise and there are many overweight people who dont. You can NOT tell a person's behaviors by looking at their body except in extreme cases.
I don't have a whole lot of time to post right now but here are just a few random thoughts for right now... For me, though I've been at a 'normal/recommended' weight in the past, its been so many years that I don't exactly remember what its like. Over the years--since HS, I've gained weight at various rates, have lost some weight multiple times during all these years but have gained it all back plus some. There's a number of factors that come into play, I'm sure. Stressors for one thing [starting college, getting married, subsequent bad marriage and divorce, multiple deaths in the family for various reasons, etc etc etc]. Activity level has also fluctuated over the years as well. However, I've gained the most weight [with a little bit of ups and downs] since 2000 when I had to go on disability for awhile. I was hospitalized a number of times and have been on a variety of medications, adding some, deleting some, based on what works, what didn't, what had bad side effects, etc. I do need to be on some medication for the long haul [as do a number of people for a variety of disorders]. And many of these can lead to weight gain and great difficulty in losing it again [but the meds are needed]. And yep, there is a lot of negative connotations from the general public for people 'of size' [too 'thin' and too 'fat']... It's one of the visable predjudisms [I know that's not spelled right] still out there in a big way [no pun inteaded]. However, that's also true with non-visable issues, too. I have a disability that people can't visably see but my disorder has been joked about, commented negatively about, lack of knowledge about, stigma, etc etc. So for both issues, I have 'issues' with the general public. Sometimes I try to educate the people/public, other times its not worth the time/hastle at the time the juegments are made. And sometimes I want my privacy protected... [more soon]
Negative connotations about being overweight have been an issue even in my family. Lots of harmful and hurtful comments and suggestions [some were meant to help, I'm sure, but many were not]. So even when I had some weight issues as a kid, I haven't been comfortable with the size issue since I *was* treated so differently, even within my family. My older sister had the opposite issue, she was always underweight yet that was viewed as a good thing. Yet she had a number of health issues, including many associated with being fat [and she did die of cancer at the age of 49]. So my self-image has most always been not very high. There have been times where I've been ok with my size [not 'embarrassed' by it or didn't see it in a negative way]. But lately, I've been going through one of my phases where I'm not happy with my appearance size-wise, even though I've lost a fair amount of weight over the past 6 months, even though I do feel good about the pounds lost. But I also wonder when its going to pile back on again as it has so many times in the past. I *am* doing some stuff to maintain or lose but overall, am not doing enough. I get so tired of the critisism from so many people about what I should or shouldn't be doing, health wise. There's only so much one can do at any time in life without getting to overwhelmed with the act of balancing one's life and other basic functions and necessities for survival. Ok, I'm drifting here, aren't I? I have more thoughts to post put its about time to head out to this evening's HH! :-)
I think that it is very common for fat people to internalize messages that our culture gives about fat people. They learn that fat people dont look good or that fat people cant possibly be healthy, and so on. Once a person honestly starts to believe those things, OF COURSE they feel bad when they are fat and feel good when they are thin. That so few fat people ever become thin people even with that kind of belief system says a lot to me.
Do you think it's possible that people have different tolerances for discomfort? Imagine youself at twice your weight, trying to get out of a low sofa? Or trying to climb a couple of flights of stairs? Would you be willing to tolerate that level of incapacitation? You've found a weight that works well enough for you. That's probably true of most people, no matter what the scale says. Maybe, just maybe, the reason lots of people maintain at 180 pounds thought they'd like to weigh less is because they aren't so much bothered by their physical limitations. Or their low self-image. Or whatever. What works for you to be content enough at your weight is exactly what works for a moderately obese person at their weight.
Nice analysis, Mary.
resp:25 I guess that is possible. However, I think there are a LOT of people who arent comfortable with their weight and who suffer quite a lot from it and who simply cannot maintain any significant weight loss. So while I suppose there are people out there who just are happy with their weight and the level of discomfort it causes, I dont think that in our present culture of discrimination and fat hatred that there are many fat people who would be comfortable with *that. But I imagine that there are plenty of people who are comfortable with the way their bodies feel to them even at very large sizes. It seems to me that things like that are likely to vary among individuals. As for me personally, it isnt so much about tolerating a level of incapacitation so much as avoiding things that make me feel miserable. There are many many things about my weight that I dont like. I imagine that anyone at any sort of size extreme might feel some of the same things. The world simply isnt built for people of my size or for very tall people or very short people. I cant even begin to tell you of the physical discomfort I feel on a regular basis because of my size. Chairs often dont fit me and are thus extremely uncomfortable, especially those little half desks they have at EMU. So yes, I am talking about physical pain, sometimes pretty bad pain too, caused because I am too fat to fit in the chair correctly. And trust me, that is just one of about a hundred things I dont like about being fat. Efforts to lose weight have always made me feel worse. And while sustained weight loss is not the typical result of any commercial diet, symptoms of starvation neurosis apparently are very common (at least according to one of the few controlled experiments on weight loss - The Minnesota Starvation Study) These symptoms are: * Cognitive processes center on food. Thoughts of food intrude constantly; the major part of the waking hours are spent in contemplating it. * Behavior includes toying with food and hoarding it, especially during re-nourishment. * Coherent, creative thinking is impaired. * Mental function is characterized by apathy, dullness, exhaustion, and depression. * Interest in sex wanes. Basically I suspect that weight is a very individual matter as is health. There are people who can eat all they want and stay thin. There are people who gain weight if they wanted to but choose not to. There are people who couldnt gain weight if they wanted to. There are people who put on weight and then are able to lose it by maintaining a state of semi-starvation for the rest of their lives. There are people who put on weight who suffer a lot if they try to lose weight. Everyone is different. And that is why you cannot look at a person's body and know very much about them at all. You cant know if that 300 lb person gets lots of exercise and eats a great diet. You cant know if that 180 lb person has more will power than some 300 lb person. You cant look at a very thin person and know if they are thin because they restrict their calories or if they are just naturally thin. You cant know if they are smart, or motivated, or lazy motherfuckers shoveling in the pizzas while sitting on the couch in their underpants. You really can not tell that by looking at a person's body.
I don't think that its as simple as people tolerating [or accepting] whatever size they are in spite of the discomforts, physical, and/or emotional limitations of being that size. Of course, there are many things or situations a person may have a range of tolerance for, but to NOT wanting to change or tolerate one thing [being overweight] when [because?] its 'acceptable' to that person [being overweight] MORE than other discomforts or situations [that it may or may not contribute to] doesn't make sense to me. It's not like many people can actually CHOOSE to lose and maintain the said weight loss or choosing not to try any to lose [or gain in the case of underweight people]the weightloss. But they/we have to tolerate the other things in SPITE of the size of the person. In another way, its not that because: 'A' [behavior] is one specific thing [a certain size] THEN you are accepting of 'B' [other 'negative' outcomes]. In most people's reality, its B in spite of A. Am I making any sense?
In rereading the responses, I do agree with what Lynne has to say in resp:27, she said it well [as in other responses, too]. More comments and such later, when I have a bit more time...
Gina Kolata, a science writer for the NYT, has recently written a book that examines some of the science of obesity. Her book is called _Rethinking Thin_. The link below is to an interview with her on NPR's Talk of the Nation. http://www.npr.org/templates/story/story.php?storyId=11606653
I listened to the podcast and found it interesting. Thanks for the link. If you accept her analysis I guess what you're left with is whether to give up and assume you're statistical fate or see if you can indeed be one of the (rare) folks who can lose weight and keep it off, long term. If you despise eating fewer calories than what you burn then I can see how you might be better off not trying to lose weight. But for a whole lot of people it's more uncomfortable giving up than not. Good thing for those who finally find some success with weight control.
Sure. It is a good thing for some people who find some success with weight control. Anyone who can lose weight and keep it off without suffering from any symptoms of starvation is certainly doing what works best for them and that is great. It is great when people win the lotto too but buying a losing ticket doesnt mean that a person is a failure either even if the success rate for losing weight is much higher than the success rate for winning the lotto. Seriously, I have no objections to choices people make about their own bodies. I am very pro-choice in every sense of the word that people get to make decisions about their own bodies even if I personally think that they are making unhealthy decisions. Mostly I think that people tend to know their own bodies. But I also think that a lot of the discrimination against fat people is rooted in a deeply held cultural belief that fat people can easily diet and lose weight and that the failure to lose weight is due to fat people having less will power or being more lazy than everyone else. If something has a 95% failure rate, that says something! I suspect too that a lot of people are uncomfortable with their weight, not because of how it makes their bodies feel but because of the way that fat people are treated in our culture. Fat people are discriminated against in many many different ways. Fat people are constantly given messages, even from medical professionals who should know better, that they just need to lose some weight and that they could lose weight if only they werent lazy people with no self discipline. People constantly get confused and see obesity as a behavior when it is not a behavior and probably doesnt even reflect different behavior than that of thinner people. And, of course, I also think that the actual health risks of obesity are hugely exaggerated. I think that getting rid of our negative cultural ideas about fat and fat people can help people make better decisions about if they want to try to lose weight or not.
the things that *is* hard about weight loss for me is I'm not sure I'll ever feel I've totally won the battle and sit back and relax. It'll be a constant thing for me to monitor and I just hope I can stay motivated. But I am ok with that. I'd rather have to constantly monitor it than to gain weight back. I've done that before, and I don't like it. So this is what works for me.
I've been thinking some of why my anecdotal evidence of friends being able to lose weight and maintain their loss is somewhat at odds with your statistics. I mean, I sure have more friends who have effectively maintained weight loss than friends who have hit the lottery jackpot. Some of it may be that they had serial-dieted without success. But along they way they'd learned some of what didn't work. So they stopped dieting and instead shifted to adapting long term weight loss behaviors - habits for a lifetime. If a researcher collected a group of dieters - they wouldn't be counted. They're not attending Weight Watchers or counting carbs or stocking their freezer with Jennie Craig. They've learned from "diets" and moved on, finding a degree of success. I'm not sure research is capturing their weight loss success. But I agree with you that obese people face discrimination and that for some, many even, significant change is not under their control for lots of reasons.
(Jeanne slipped.)
I completely agree with the discrimination, and it's sad. The think that irritates me about it is that there are people who make lots of bad choices in their lives (like drinking, smoking, drugs, etc.) that don't effect they way they look, yet some day their actions will result in some sort of consequence most likely. So they bitch about fat people when it is only because of the way they look and it is hypocritical. I worked with this guy and he hated me because I was fat. I was so appalled by him, but I was always really nice to him. I finally asked a coworker why he was so mean to me, and he told me. I was just flabbergasted. It's very sad.
resp:34 It may be the case that people like your friends who arent on official diets are not reflected in any studies. Certainly they or people like them wouldnt be included in studies of specific diets. But it could also be the case that they have been included and that it is a coincidence that you happen to know people who have lost weight and kept it off for years. Or maybe not so much of a coincidence...I can recall reading of one study that showed that socio-economic class was a factor in sustained weight loss with people in the higher socio-economic classes more likely to lose weight and keep it off. There are also studies that show a correlation between income and weight. There certainly is a connection in the public psyche. I imagine that you probably know more people in the higher socio-economic classes than in the lower ones. There might have been studies though that show that making permanent lifestyle changes yields more success than going on a diet with the idea that the diet is temporary or at least I remember reading that and somehow got that idea in my head. It was one of the main reasons I stopped going on diets. I would think to myself,"is this something you want to do for the rest of your life?" and for me the answer is pretty much always "no," But obviously for your friends, the answer was different. Which kind of leads into furs's comment in resp:33. Most likely, furs, you will need to monitor your weight for most of the rest of your life. If doing that is ok with you, and it sounds like it is, then clearly you have made the right choice. The hypocritical health concern made by people with plenty of unhealthy habits always bugs me too. The employment discrimination does as well. Also the discrimination in health care. And all of the thousand messages everyone in our culture is bombarded with every day that being fat is not ok and that fat people are bad people.
Just in case anyone was in doubt about the nature of fat hatred in our country, consider the following essay. Apparently fat people are responsible for pretty much everything that is wrong in our country. Or rather "The fat on our bodies is simply the external manifestation of the fat that infects the national spirit the corruption of our most sacred institutions, the incompetence of our public servants, the erosion of our civil liberties and the apathy that weighs us all down like a double Whopper with cheese." http://www.newsreview.com/sacramento/Content?oid=344915
From today's Dean Ornish column in Newsweek http://www.msnbc.msn.com/id/19617152/site/newsweek "A new study published this week in the prestigious journal Nature Medicine looked at the effects of stress on weight gain in mice. Investigators reported that chronic emotional stress turns on a peptide (chemical messenger) called neuropeptide Y, which is found in body fat. This hormone increases appetite, especially for carbohydrate-rich foods. It also causes your body to convert these calories into belly fat, a double whammy. What's especially interesting is that chronic stress alone didn't have much effect on weight gain in only two weeks, nor did a high-fat, high-sugar diet. However, combining both together was especially toxic and markedly increased abdominal fat deposits in only two weeks. When the researchers blocked the effects of neuropeptide Y, it reduced stress-induced visceral (belly) fat by 50 percent "without any discernible effect on food intake, which remained as increased as it was" according to the investigators. In other words, they ate the same amount of food, didn't exercise more, yet their belly fat decreased by half when the effects of neuropeptide Y were blocked. This is amazing stuff." ---------------- First time I've seen research that begins to explain why some people might not be able to lose weight even by eating fewer calories.
Yeah, that stress research has been ongoing. It is nice to see that it continues. I have heard it as a possible explanation for some of the differences in weight among people of different socio-economic classes. There is also some research that suggests that belly fat increases certain hormones that in turn cause a person's body to become resistant to insulin (aka type 2 diabetes). So if a drug could be developed that prevented the belly fat, it might also be something useful in treating diabetes. There really has been a lot of research in this subject because, let's face it, there is a huge economic insentive here. Can you imagine how rich a drug company would be if they actually could develop a drug that caused people to lose weight without the terrible side effects of current and past weight loss drugs?
[Lots of interesting stuff posted here since I was here last... I'll have to come back and check out some of the links and such sometime soon when I have more time to read and think about it, then post comments.]
You have several choices: