(no subject)

Friday, 31 July 2009 07:55
earthbelow: (Default)
Dear Nightly News and The CDC,

You fail at responsible journalism and health statistics, respectively. I watched ABC Nightly News' report on "The Cost of Obesity", in which they stated that "obesity related health care" costs on the order of over a $140 billion dollars a year.

This is for the fail, and let me tell you why.

1. The CDC does not actually know which diseases are obesity-related and which are not. What they are really calculating is the cost of healthcare for obese people, and since 2/3rds of the American population classify as "overweight" or "obese" under their guidelines, they are calculating that it took $140 billion to care for 2/3rds of the population.

2. They assume that every disease an obese person gets is related to their obesity. This is patently untrue. I am not denying that there are conditions which are affected by weight. There certainly are. But there are also a lot of conditions, many of which get counted under the obesity umbrella, that medically aren't tied into a person's weight. There are also conditions caused by other factors. Smoking, for instance. If someone is obese and a smoker and has high blood pressure and cardiac problems, counting both of those strictly as "obesity-related" is stupid. There's no way to know whether it's because of the obesity or because of the six packs of Marlboros a day.

3. I don't see the CDC studying the diseases that thin people do or do not get. Is the rate of heart failure, high blood pressure, and diabetes really that much lower in the "thin" population? Because studies are not being done on thin people, only fat people. I would wager that it is not actually all that much lower, but that thin people are given access to treatments and proper medical attention that fat people are not, thus their conditions do not become chronic. Whereas a fat person with the same complaint may only be told to "go hit the treadmill, fatty" instead of being given medical treatment.

4. This report does nothing useful to help people better understand healthcare, their bodies, or obesity. Yes, the healthcare costs are high, but much of that does not actually even go towards patient treatment. Spending does not equal treatment. A lot of that money eaten up by other non-medical factors. Nor do they factor in that a lot of obese people aren't getting any medical treatment, either because they don't have access to it, or they don't get it from their doctors. I don't think that the one time I managed to get in to see a doctor who sat me down and told me how fat I was for an hour should count towards that total. Especially when the cost of that visit wasn't in treating me, it was in paying the doctor for his oh-so-unhelpful lecture. I never actually received any treatment.

5. This report does not specify who counts as obese, or as "people". Is healthcare spending on children included, because we do spend more on children's healthcare. Not due to obesity, but because people actually seem to care whether a child can see a doctor. Never mind if the parents can, or childless adults can. As long as the children can. See above: SPENDING DOES NOT EQUAL TREATMENT GIVEN.

6. This report does not specify what counts as a healthcare cost. Is it just the cost of prescriptions, treatment's, and doctor's visits or are you including the salaries of doctors and nurses as well as the cost of running hospitals. I don't think obese people should be held responsible because doctors are demanding to be paid more, have to raise prices because of malpractice insurance, and pharmaceuticals are expensive. That hikes up the cost of everyone's healthcare, and isn't caused by anyone weight. Fat people aren't making the cost of malpractice insurance rise, I promise you.

7. The cost of healthcare for thin people was never mentioned. Funny how that works. Maybe because the number isn't that much lower?

8. This report does not state who is doing this spending. Because much of that number comes from the out-of-pocket costs that fat people themselves are paying because of a lousy healthcare system that treats them as subhuman.

9. The report does not state how much of this number goes into preventative care. It should. Because I think if we saw the amazingly low amount being spent on preventing diseases through regular doctor's visits and affordable healthcare, people might not be inclined to feel that "the fatties are bringing down the healthcare system".

10. The report was inflammatory without being informative. The inclusion of "headless fatties" and mention of the number in the "struggling healthcare system" can only be meant to encourage prejudice against fat people rather than responsibly disseminate information.

In conclusion, you suck. You just added to all the prejudice, hatred, and mistreatment that fat people are getting in this country. And for what? For nothing. For a lousy two minute fluff piece.

Thanks for making things worse than they were, ABC News and the CDC. You two stay class.

No Love,
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.
earthbelow: (Default)
After reading the manifesto over at [livejournal.com profile] fatshion_victim, I felt the need to make a post. Say something. Respond.

Confessions of a Fat Girl )


earthbelow: (Default)

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