earthbelow: (pensive statue)
[personal profile] earthbelow
I found this article on possibly "curing" obesity with cancer drugs, and I expected it to be a lot more insulting than it was.

While I'm sketchy on the science, and I'm not sure I like the idea of someone coming up with a drug that could have such severe side effects that could "cure" obesity, because I think a lot of obese people who are perfectly healthy and happy with themselves would be pressured into doing something risky in order to fit in.

I know that since the advent of weight loss surgery commercials on TV, I've had family members ask me why I haven't considered and undergone it. Never mind that I can neither afford it nor want it. They want to know why I'm not running to the table to have my digestive tract surgically rearranged. And that hurts, because it's more than clearly implied that I must be defective, lazy, or willfully fat if I'm not rushing to have that done so I can fit in with society's norms.

Because god forbid I should take the slow and steady route and exercise and eat healthy and let my body decide where it naturally needs to be.

Still, aside from that, this article did contain some actual common sense and scientific thinking, such as this gem:

"Conventional wisdom is that people become obese because they overeat," says Hughes. "But the fact is that in an environment where people are exposed to the same food supply and lifestyle, some will gain weight and others will not."


*gasp*. You mean, maybe, just maybe, the fat people aren't all that much lazier or overindulgent than the thin people? Are you trying to tell me that the thin people aren't harder working or healthier or better, that maybe they're just...*gasp*...luckier? But that's ludicruous! That would mean we'd have to use science and treat people with compassion and that we'd have to do tests and examinations and use our doctor learnings before we could judge them instead of being able to diagnose them at a glance! We'd have to use ACTUAL SCIENCE!

Oh, I can't bear the thought. *swoons*.

Okay, my sarcasm aside, I have to say that the idea of finally treating obesity as what it is - a physical attribute, not an infallible indicator of lifestyle or personality - strikes me as the real breakthrough in this article. Drugs that try to make people eat less don't concentrate on the fact that if overeating were really the problem, then we'd either have far more obese people or far less, depending on what you believe about the American diet. I think if obesity had a straight, 1 to 1 correlation with eating and exercise levels? Then 90% of America would be obese.

Yes, you can lose weight by just not eating. It's called starving yourself. It does, after a fashion, work. But unless you do it all the time, it's effectiveness as a long term solution doesn't work very well. And while, yes, looking at your dietary intake with close scrutiny and cutting down or cutting out unhealthy foods is always a good idea, not to mention that getting exercise is a good idea - there does come a point when all that still might not suffice.

Adipose tissue is not a moral indicator light. It's a physical attribute. And yes, I do believe there is such a thing as having too much adipose tissue, but I don't think that number should be set strictly based on just height and gender. I think a determination of health should be made based on whether that adipose tissue is actually affecting your health. As in, with empirical evidence, not just some doctor saying, "Well, you have diabetes, it must be because you're fat!"

One day we're going to discover (and by discover, I mean some scientist is finally going to make that almighty proclamation from the mount that gets doctors to change their tune) that a lot of obesity is actually the symptom, not the cause, of a bigger root disease that we're not seeing, and that we've really been misdiagnosing and mistreating folks due to their size. I think sometimes, saying "diabetes causes heart disease, diabetes, cancer, zomg!" is like saying that coughing too much causes your sinuses to clog up and your body to feel tired and your temperature to spike. The coughing is not the cause, it's a symptom. You're tired, achey, clogged, and feverish because you have a fucking sinus infection and you need medicine, not because you chose to cough too much.

Taking the analogy further, handing out nothing more than cough drops and bad advice to chronic coughers is useless, because cough drops do not cure a sinus infection. Whether or not you stop the coughing is irrelevant, you haven't cured the disease. Unless you either give them antibiotics or their body fights off the infection, it just gets worse and worse until a sinus infection becomes an upper respiratory infection which becomes pneumonia which becomes death.

And to quote House? "In case any of you missed that class in med school, that one's untreatable."

I think it's the same with obesity. A lot of the "obesity epidemic" is probably an underlying public health crisis that is going unexplored because the fat is more visible and more socially stigmatized. It's just easier to say that people are lazy. Because then we don't have to treat them or care about them or respect their humanity - and unfortunately, it's human nature to find any excuse not to give a shit about other people whenever possible.

Date: 15 Jul 2009 14:42 (UTC)
From: [identity profile] tptigger.livejournal.com
This post makes me think of the House episode "Heavy".

For whatever that's worth.

Also ::hugs:: just 'cause.

That and I wish you could find a good doctor who treats the whole person and not just the empirical.

Date: 15 Jul 2009 18:15 (UTC)
From: [identity profile] thousandpages.livejournal.com
This post makes me think of the House episode "Heavy".

Yeah, and what made me upset was that the episode was actually very realistic as far as the level of care she got from the team. What's worse is that the ep focused on how much Chase was anti-fat, but you didn't see anyone, even House, saying, "what if we assume that she isn't a fat slob for a moment" early on in the diagnostic. Plus, the little girl's illness was rather easy to diagnose once someone saw beyond the fat.

There are so many kids like that out there, who's health problems are causing weight problems, but they get blamed for the reverse.

That and I wish you could find a good doctor who treats the whole person and not just the empirical.

I wish I could, too. A lot of us bigger folks have this problem of not finding decent health care providers - that is, when we can actually get access to healthcare. I mean, it's been a struggle for me just to keep insurance and be able to go to any doctor at all!

I'm just hoping that as science progresses, some of the prejudices concerning obesity will start to lessen or go way when some of the common "myths" about it get disproven in the laboratory.

Date: 15 Jul 2009 14:49 (UTC)
From: [identity profile] denoue-moi.livejournal.com
I hate it when docs decide to treat patients like obesity is a fault. Whether it is or not, could they at least treat patients?

I've had a GP and a GYN refuse to help me because I was faaaaaaat.

The GP said that the meralgia parasthetica in my left leg was due to the faaaaaat, and that I had to lose weight. She refused to give me non-narcotic, non-addictive pharmaceuticals to block the nerve pain. Luckily, it went away on its own without losing weight after a few months.

The GYN said that my period agony was due to being FAAAAAAAAAAAAAAAAAAAT. She said that my estrogen levels were higher because of it. She said this without doing any blood tests. She said I should lose weight and then the hellcramps would stop. Well, I'm not skinny yet, but so far her theory is made of fail.

They're pretty much telling people, if you're fat, you deserve whatever agony that may or may not be related to your fatness.

Come on, docs, help us. Don't punish us.

Date: 15 Jul 2009 18:25 (UTC)
From: [identity profile] thousandpages.livejournal.com
Whether it is or not, could they at least treat patients?

INORITE?! There are times when I get really upset that people who do things that are way worse than overeating/not exercising and they can walk right up into a clinic or a doctor's office and get excellent, sympathetic care, but go into a doctor's office while fat? You're barely worth treating.

I wish there was a way for patients to lodge complaints against doctors for this where it would actually help. And I wish there was a system where fat people could, at the very least, warn each other about fat-phobic or and fat-hating doctors. You know?

There should be a law or something that if doctors and pharmacists have certain prejudices or beliefs, they HAVE to tell you before hand. Like, if they're one of the "I don't believe in birth control pills" crowd, they have to have a huge sign and a disclaimer and a waiver you have to sign so they you know, before you waste time, energy, and money, that this person is not going to help you. And I think that doctors who believe certain things about fat people should also be required to declare that.

I swear to fucking god, the next time I encounter a doc who is fat-phobic like that, I am going to just lose it. Right there. I'm tired of being scared and ashamed. I am just going to lose my shit right there in the office, because obviously being a good little patient doesn't work and you STILL don't get treatment.

Date: 15 Jul 2009 22:29 (UTC)
From: [identity profile] denoue-moi.livejournal.com
I don't blame you. Maybe they need to be called out on their BS.

Date: 15 Jul 2009 15:56 (UTC)
br0ken_dolly: (Default)
From: [personal profile] br0ken_dolly
"Conventional wisdom is that people become obese because they overeat," says Hughes. "But the fact is that in an environment where people are exposed to the same food supply and lifestyle, some will gain weight and others will not."

this really needs to be beaten into all doctors with a metal studded baseball bat.

doctors have been trained to mistreat patients based on a physical attribute. that fact that we're all living the same lifestyles and yet a third of us are fat tells any rational person that perhaps it's a symptom and not a disease. (which is what i posted the other day. i'll revisit it soon.)

Date: 15 Jul 2009 18:38 (UTC)
From: [identity profile] thousandpages.livejournal.com
that fact that we're all living the same lifestyles and yet a third of us are fat tells any rational person that perhaps it's a symptom and not a disease.

Well, what upsets me is that there isn't really even any research into why, if 1/3 of us are fat, what's keeping the other 2/3rds so thin? Are they really doing more hours of exercise, eating less, eating better? Because you'd think if people were so concerned about obesity as a health epidemic, they would at least study the thin people.

But nobody does that. Nobody asks, "Why aren't these people fat?"

Nobody actually bothers doing a survey of how much exercise everyone is getting, how much food they're eating (what kinds/amounts) and actually PROVING that there is a correlation. Because I think you'd find that a lot of thin people are doing lots of terrible things, they just drew a luckier straw than the fat ones.

I guess I'm frustrated because my sister and I grew up in precisely the same environment, eating the same meals, doing the same things. Hell, we pretty much lived identical lifestyles from birth and we're only 14 months apart in age. We might as well have been twins. Yet, somehow, someway, my sister has never been overweight in her life and I've been overweight since I was about seven years old. I don't know how, but somewhere around second grade, I started putting on weight that I was never able to shed.

And it wasn't like we had different activity levels back then, either. We both took gymnastics, rode our bikes, played outside, had a damn trampoline. Most of the times our activity and food levels were mandated by someone else (parents, school, daycare, etc) so even if I had wanted to be less active/eat more I couldn't have! Yet somehow, she's thin. I'm not.

Come on, you can't tell me that at age seven I began to eat so much more than my sister and exercising so much less that I put on probably twenty pounds (which, at age seven, is a big damn deal) and she didn't. Because I didn't control my food back then. My sister and I ate identical things - and since we were so close in age we both went to the same school and there were times we ate at the cafeteria at the SAME LUNCH PERIOD! At some point, when you see two human beings with nearly identical starting points end up somewhere that different though they have identical lifestyles, habits, genetics, and activity levels, something else is at work.

And I'm so frustrated that science hasn't caught onto this because they're so busy trying to tell us how much this is all our fault and we're a big fat (pun intended) burden on the healthcare system (actually, no, we're not. People having babies is actually more of a strain on healthcare than obesity) instead of fixing the damn problem.

Date: 15 Jul 2009 19:17 (UTC)
br0ken_dolly: (Default)
From: [personal profile] br0ken_dolly
that bothers me too. and i GUARANTEE that thin people are exercising at a rate pretty comparable to the rate at which fat people exercise. i know thin people who eat absolute GARBAGE and don't exercise, and stay thin without any effort whatsoever. i can think of one girl i knew in new hampshire who never weighed over 92lbs (at 4'10") and went to mcdonalds several times a week to eat 5 or 6 cheeseburgers at a time (with fries and sugary soda) for a meal. and for other meals she hit up other fast food joints. my exgf was pretty similar-- ate huge meals all the time, and never got heavier than 115lbs in college. (she put on a little when she lived in her pajamas all day every day while i supported her, but hey, that's understandable.)

yes, i know that unhealthy diets can and do contribute to weight gain, but like you said-- why doesn't it ALWAYS contribute to weight gain? plus there's the fact that not all fat people get "fat diseases" so there's that to be researched, as well. it's very possible that fat actually is NOT the determining factor for whether or not someone gets type 2 diabetes or heart disease, because thin people get these, too. perhaps it's an endocrine issue.

i was fat from toddlerhood. i do have some blame that doctors told my mother i needed to have formula (mixed with full-fat milk) until my 2nd birthday, even tho i was being weaned, and i think all that fat contributed to me being fat (althoughi also think the MILK fat did more damage than if it were a healthier fat), but on the other hand, there were plenty of other mothers who got teh same advice in the late 70s, and not all the toddlers got fat like i did. even when i was exercising regularly (2 hrs/day about 5 days a week) and had a job where i was on my feet all day and lifting heaving people all the time, and hardly eating anything but salads (and one bag of m&ms a night, cuz that was my treat to myself despite being poor), i never lost weight. i gained a little muscle, but i never lost weight. and that was TWO HOURS A DAY every day (on top of a physically demanding job). that's NOT REASONABLE. and of course i worked with other people who were thin as a rail and ate junk food all night long. (when i'd go get my m&ms from the vending machine, my thin coworker came with me and got 3-5 treats on any given night! and she didn't work out!)

my sister was also pretty thin. i think we were similar in weight for a lot of childhood, but she's almost 6' tall and i was 5' until i hit 18 or so. so she "grew into" her body weight, and stopped gaining when shit hit her teens (where i gained 10lbs or so a year up until a few years ago). our diets weren't that different (in fact, i ate better because of teh vegetarianism and she eats SO MUCH fatty food).

there's a LOT that doctors dont know and they're spreading a LOT of misinformation and practicing poor medicine.

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earthbelow

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