Wednesday, 15 July 2009

earthbelow: (pensive statue)
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.

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