Monday, November 09, 2009

Fat Karma: Morbidity and Weight

Invariably, if you try to say we should stop talking about weight, someone responds as if you are saying you can do whatever the hell you want, as if you are saying we shouldn't care about our health. It is difficult to get folks to understand that weight does not necessarily correspond to good or bad health habits.

I've been thinking of doing this series for a while. I'm sure the seed began several years ago when I read Paul Campos' The Obesity Myth. I finally took the plunge when I got into a series of disagreements with someone on facebook regarding the Moral Panic I'd been witnessing in the whole Health Care Reform debate. Just as an aside, I am not hopeful about the thing called a health care reform that just passed the House. It guarantees insurers that every citizen must buy insurance. What a corporate windfall. And while it says they cannot refuse to insure people, and cannot raise the premiums of sick people, it does not say anything, at least that I have heard, that those who are in a supposed high risk category and mythically can choose not to be, cannot be punished with higher premiums. That is, if you're fat, you'll pay, and if you can't afford the premiums, you'll pay fines. So, back to the disagreements. This person dismissed this quote from Campos from the Moral Panic article, "After twenty years of studying this complicated issue, I cannot offer any meaningful public policy suggestions, but I do know that we should all stop talking about this issue." He took a whole book to prove that point, and she can dismiss it from a quote from an article.

What Paul Campos found in the studies was that only the underweight and the extremely overweight are at greater risk of earlier mortality, and in fact if over 65, to be what is considered "overweight" is actually a health benefit. Yet there is a common belief that simply to be overweight is deadly, and to be morbidly obese, as I am considered to be, is beyond the pale. A couple of eye-popping statements in the online comment-troll world keep surfacing on such articles. 1. You don't see any fat old people. and 2. I'm not sure which is worse, obesity or smoking. These are such extreme versions of the age-old fears of simply being fat, with health having nothing to do with it. I thought, huh, so people still do choose smoking over gaining weight. What Campos also found was that most people who do worry about their weight have no reason to...their weight level has no effect, or has a positive effect, on their health. What he found is that people do attach a moral component to a person's weight. People attach a measure of self-worth, and with that as your measure of health, you can never win the fat fight.

For a while I thought about reading boards about weight loss, what people say about how they feel so much better. How now they can go dancing, now they can do this or that with their kids. How much happier they are. How they can let themselves be seen in public. How they can date again. I suspected a good 80% of the comments would have nothing to do with their physical capabilities. People measure the negative health impact of their supposed excess weight by how they feel, when how they feel is measured by their feelings of self-worth, not their actual physical health. The only thing holding people back from active participation in the world is their own negative feelings about their bodies, and nothing else. I could say the same about those commercials for the evil bariatric surgeries.

You know what, I can't run fast, but I can run, even though I am bearing a weight load. If I am climbing or descending stairs, I must be aware of the load I am carrying, with my head and shoulders and knees aligned appropriately with my center of gravity, just as a weight-training athlete would. I can still dance. I can still date. I can still be seen in the world. I can still eat in public, even though I'm fat. What others think of me doesn't and shouldn't matter, yet that is part of the reason why some people feel they need to lose weight. My allergies limit my participation in worldly activities more than my weight does.

If I wish to be healthy, I do need to be concerned about my cholesterol levels, my blood sugar levels, my blood workup indicating vitamin D and iron and other minerals. The Framingham Heart Study does not list obesity as a predictor of coronary heart disease. Number one predictor? Age. Pure and simple, we get old, we're gonna die. All this worry about weight's gonna make us die young, the doctor actually telling me, without studies proving this, that it will shorten my life, this is all about getting old, dying. Well, we're all gonna die. Chances are I will have little say as to when. Next predictors: diabetes, smoking, blood pressure, cholesterol. Guess what folks? In two years, I have gained a little weight, what, maybe 10, 20 pounds. And my cholesterol and my blood sugar levels have gone down. Weight has nothing to do with it. Indeed, how I feel about it has a lot more to do with it, maybe as much as that balanced diet thing. More on that in an upcoming post. My blood pressure went up slightly, which with the help of the lowest level of bp meds, is now lower than it's ever been in my adult life. It and high cholesterol run in my family, no surprise there, whatever I weigh. Funny thing though, when I run my numbers, whether I use my pre-med high systolic blood pressure of 160, or my med-induced number of 110, my 10 year risk of heart attack is still less than 1%.

By the way, without even starting on the ill-advised voodoo nature of wishing negative outcomes on someone, what useful meaning does that have, to tell someone, "This will shorten your life." ? You may think you have a statistic, but you can't apply that to an individual. You have no idea how long I would live in a perfect world, so how can you subtract days, months, or years from that?

I don't like the word "obese," much less, of course, "morbidly obese." These words hold a judgment in the view of many as a death sentence, and at least severely sickly. I'm pretty sure most fat people prefer the descriptive word "fat." If I am sickly at any point, it is more to do with my allergies than anything else. I haven't had the flu in over 20 years, and I've had a cold maybe once in the last 10 years. I have mild asthma, but I don't need to take regular medications for it, and I use a rescue inhaler so rarely that my prescription keeps expiring. My health indicators are all good, and even better since I have been able to act on the information from that blood workup.

Funny thing is, I was blaming my weak knees on my weight, thinking, well gee, they have to work hard, maybe they're wearing out. The erstwhile Facebook friend tossed that out as a bugaboo one time when she couldn't slap down heart disease as the bugaboo, and I would have agreed with her. Actually, it was a Vitamin D deficiency. Many of us in the Pacific Northwest have a Vit. D issue. I wonder how many people suffer from failing knees who could have used a massive Vitamin D boost? When I was getting my new CPAP machine I met a woman in the waiting room in a wheel chair because she needed knee surgery. They won't give her the knee surgery until she loses weight. I found myself wondering, how can they expect her to lose weight if she can't move? She said it had to do with being able to bear the weight to recover. My thought is, what, can't they develop alternative recoveries? People have amazing artificial legs available these days...if these can be developed, why can't there be as amazing a solution to easing the weight-bearing load on a recovering knee? The thing is, my erstwhile Facebook friend had tossed this karma out there as blameworthy. It is our own damn fault if we wreck our knees because we allowed our weight to get so bad as to wreck them, so we deserve to live with it if we don't lose the weight.

Another funny thing, I was blaming my occasional shortness of breath on my fat too. Makes sense, wouldn't we all? But that turned out to be due to an iron deficiency. Regular imbibing of iron, then wow, no shortness of breath. Turns out this is a symptom of anemia. Once diagnosed, I thought, duh, I should have known, I'm a vegetarian. But this hadn't been an issue, though I've been a vegetarian for 20 years. Only in the past few years, my monthly blood flow has gotten heavier, thus, anemia. These are ways in which doctors hurt us, if they don't seek out other possible causes, and we hurt ourselves too, when we blame only the fat.

I'm trying to use the obesity word a little bit, though. Perhaps I can be an example. See? I'm what they call morbidly obese, yet my indicators show that I am in no danger of diabetes or heart disease, even though the fat-fear-mongers would fling these at me like sticks and mud and stones. See? My favorite place to shop is the farmer's market, and my favorite meal is probably Tom Kah soup with lots of veggies. See? When I am given identifiable tasks that will improve my health, I take them and my health improves, without a diet having to enter into the equation, though it can mean a change in diet.

Coming soon: Voodoo Hex of Fat Fear, Breaking the Diet Habit, Confessions, and more.

Earlier posts in this series:
It Starts Young
Health Care Bigotry

1 comment:

I AM ANOTHER said...

Hi Heidi, just stopped in to catch up a bit. Hoping life is well for you. Thanks for writing as I really appreciate your sharing. Much love.