Lara Frater's Blog, page 10

Finding blame and paying more

At one of my physicals, the nurse taking my vitals wanted to weigh me. I don't get weighed at the doctor's office and told her so.  (If the doctor really wants to know my weight, I'll be willing to be weighed by him in private as long as the number doesn't go into the chart. That hasn't happened.) She said that some insurance companies want the number. I told her that that was one of the reasons I didn't want to get weighed.

I get my insurance through my job and at the moment there are no extra charges for perceived health issues. There are discounts to diet programs and gyms. I worry constantly that this will change. Other places already are looking to hit people while they're down.

For the past few years, companies have experimented with tying health
insurance premiums to people's health. Here's how it works: Employees go
through medical and biometric testing as part of their health insurance
open-enrollment process. They are weighed, their height and blood
pressure are measured, and their blood is drawn. Those with high scores
on cholesterol, glucose and blood pressure -- or with chronic conditions
like diabetes -- are told they will have to pay higher premiums unless
they actively try to address any risky conditions.

One of the reasons I am very pro-universal health care is that when we have for-profit system of health care, people who tend to be genetically prone to certain diseases will be charged more or denied coverage. It's a slippery slope that this will condemn all fat people regardless of their health.

Meanwhile UCLA Professor Abigal Saguy points out in her op-ed about fat prejudice.

Despite the fact that body weight is largely determined by an individual’s biology, genetics and social environment, medical providers often blame patients for their weight and blame their weight for any health problems they have. 

Health insurance isn't like car insurance. Driving a car isn't a right: you need to demonstrate your competency through your actions. Health insurance means that you don't go broke for an illness, acute or chronic. I don't get the logic of telling people they need to get healthy before being allowed access to health care. 

The good news (for the US) is that in 2014 you cannot be denied health insurance based on health status. It also means there are affordable health care options. This is good news for fat people who often are either denied health insurance or given outrageously high priced options.

Health insurance companies offering coverage to individuals and small
employers will only be allowed to vary premiums based on age, tobacco
use, family size, and geography.  Basing premiums on other factors will
be illegal.

 

Not a Glutton

The fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM) Version 5 will be out in the Spring of 2013.  In it Binge Eating Disorder (BED) will be added for the first time, defined as this: 

Criteria include frequent overeating—at least once a week for three months— combined with lack of control, marked feelings of distress, and are associated with three or more of the following:
eating much more rapidly than normal
eating until feeling uncomfortably full
eating large amounts of food when not feeling physically hungry
eating alone because of feeling embarrassed by how much one is eating.

Dr. Allen Frances of Psychology Today lists the 10 worst issues in DSM 5 and one of those issues includes BED: 

Excessive eating 12 times in 3 months is no longer just a manifestation of gluttony and the easy availability of really great tasting food. DSM 5 has instead turned it into a psychiatric illness called Binge Eating Disorder.

For an MD, Dr. Frances appears to know very little about eating disorders and more about giving moral judgements upon overeaters, essentially calling them gluttons. 

BED isn't overeating at a fine restaurant or at a great meal, it's compulsive overeating past the point of fullness, without taste or enjoyment. It's similar to bulimia but without vomiting. 

Now as far as BED being listed in the DSM, I have mixed feelings. On one hand, having suffered from BED, it's nice to see it acknowledge as something real instead of "Stop eating so much, fattie." However I am wary that its being added opens up a psychological issue to diet drugs. Something I have repeatedly mentioned never work.  And I worry because the American Psychiatric Association which is not known to be fat positive is adding not adding BED because how it affects the self esteem and well being of the person, but because the worst case scenario is they might become fat. 

Fat, Love, and Self esteem

Until I began dating my husband Jon, I was certain I was going to I was going to die an old maid. I had piss poor very brief relationships either with idiots or assholes.

I meet Jon in college. We were both members of the English Club. Jon was a computer/sci-fi geek and I wrote poetry about death. (Seriously, I was known as Miss Death and people would yell out death, death when I got on the stage at monthly poetry readings.) In the beginning Jon and I were friends. I was painfully shy and certain that no man would want a relationship with a fat girl. (There were in fact 2 or 3 men in college that liked me but didn't want a relationship), but I was hung up on getting into a relationship like my other friends hopefully with someone good looking.

I think that I set off two vibes, one I was ashamed of my body, and two, I didn't think a fat girl deserved anything. I was absolutely sure from the ages of 14 to 23, if I lost weight I would find a guy.

After college Jon went to Japan for two years and I went to Graduate School. I had no boyfriends in this time, except someone I sort of fooled around with and someone who met me, talked to me, seemed to like me, then for some reason backed off.

During every fling, date, or episode of "just friends making out" I dieted, and was ashamed of my body. It never occurred to me that it wasn't the fat that turned people off but the low self-esteem and belief I could diet my way to a good relationship.

Jon and I really didn't stay in touch during those two years but we shared a best friend. She was having a baby and wanted us to be the godparents. When Jon came back from Japan, I happed to be in a period of not dieting. It was after I realized Weight Watchers was never going to work and I haven't yet been introduced to low carb. I was still convinced thin was in, but that belief was beginning to wane. I started to think maybe I wasn't meant to be thin. In fact I began to learn to love my body and accept it.

It's no surprise that soon after Jon came home, we hooked up. Jon was funny, good looking, had an easy going nature, and could tolerate both my shyness especially around my body and my quirky sense of humor. 

We dated causal at first, then it got more serious. We eventually married in 2000. Jon was not only my husband but my first long term relationship. He doesn't like it when I say it, but my relationship with him is the one part of my life that came out as I wanted. I've always been glad that he tolerated my low self-esteem. He is one of the few people I have no problem parading around naked in front of. Jon loves my boobs and he loves to squeeze me. He likes big women and he never hates a person for how they look.

I'm in the process of reading Fat Sex  by Rebecca Jane Weinstein. The book isn't about Fat Sex per se, but instead fat people talking about sex. (I'd suggest Big Big Love by Hanne Blank as a good guide to actual fat sex.)

In the book there is a chapter about an FA who is often ribbed about his love for big women. I laughed because none of Jon's friends have ever ribbed him for me and he never ever thinks of me as an embarrassment. I'm sure the beautiful people laugh at us but neither of us care. 

The object of this post isn't that fat women can snag a man. Yes, they can. There are plenty of men who like big women or prefer personality over looks. The point here was it was the low self-esteem that turned off men. That in order to be loved, you have to learn to love yourself first. 

 

New England Journal of Medicine - Don't help.

Recently the New England Journal of Medicine came out with a "Study" showing seven myths and six assumptions about "obesity" Although not a single one is a myth or presumption about fatness, say how the obesity epidemic is overblown, how being fat doesn't affect your mortality except for the supersized, or how everyone ignores the rise of dieting came with the rise in fatness. Instead every single one is about weight loss/ dieting. Some of it is fairly harmless like sex only burns about 14 calories compared to 300, or that breast feeding doesn't make your kids thin. Please don't stop having sex or breastfeeding because of this study as both have health benefits. Others aren't as helpful, that gym classes don't make you thin. That's right they don't, regular exercise for most people despite their size makes them healthy, not neccessarily thin. 

Normally I would say this is a positive article because it shows that healthy habits don't actually mean weight loss. 

Until I got to one of the myths.

Within weight-loss trials, more rapid and greater initial weight loss has been associated with lower body weight at the end of long-term follow-up

Essentially the "Myth busted" is that rapid weight loss works better than steady weight loss. The authors point out that some people have been successful at it. Depends how you define success. In 1999-2000, I was a success. I lost 35-40 pounds (I was still fat) in about 6 months and while I never got to a goal weight, I kept the weight loss for another year. But a year after that I was back to my original weight. A number that I've hovered within 10 pounds of for the last 10 years. I never said people can't lose weight, I said they can't keep it off in the long run. Whether they lose it slowly or quickly. 

Rapid weight loss can lead to gallstones, and loss of vitamins and minerals.  Most rapid weight loss comes from very low calorie diets either liquid diets or weight loss surgery which means you aren't eating enough for your body to function properly. 

I think Marion Nestle hits the nail on the head on the reason for this "study".

"I think it’s weird.  I don’t get it," said Marion Nestle of New York University. "I can’t understand the point of the paper unless it’s to say that the only things that work are drugs, bariatric surgery, and meal replacements, all of which are made by companies with financial ties to the authors. " She noted that the researchers who signed the paper also provided a long list of companies they have been paid to work with. 

If you read the affliations, you get big food, big pharma, and the diet industry. As mentioned last week, the diet industry is expected to make 66 billion in 2013.

Not surprising that they want you to not eat healthy food and exercise (To be honest they don't actually say that) and instead to take drugs, get surgery, and go on crash diets. 

 

Guess what still doesn't work? Stigma!

I have mentioned repeatedly that stigma  not only does not make you thin but can cause health issues due to stress, fear of exercising and binging. 

I'm not a lone crazy for saying this, even groups that encourage weight loss such as the Rudd Center believe that stigma does not work and is harmful.

Of course you can't tell that to the Hastings Center Daniel Callahan who writes in his article (PDF)

It will be no less necessary to find ways to bring strong social pressure to bear on individuals, going beyond anodyne education and low-key ex- hortation. It will be imperative, first, to persuade them that they ought to want a good diet and exercise for themselves and for their neighbor and, second, that excessive weight and outright obesity are not socially acceptable any longer. 

He then continues that more stigma not less will help fat people become super thin. He essentially wants to make being fat unpopular like smoking but being fat isn't a habit. 

It won't work. It won't work because diets, "lifestyle changes", stigma, financial incentives, penalties, and eating less calories than your body needs  does not work for most people in the long run. With 20 million dieters, I'm sure you're going to find some who succeeded but most won't. With almost 40 years of yo-yo dieting, we're aren't getting thinner and dieting is causing a lot of the weight gain. (As I have mentioned before, I estimate about 50 pounds of my weight is from dieting)  And what happens to people who despite Daniel Callahan's whipping and screaming at them to lose weight,  still fail to do so? (Hint: tough shit.)

He says that fat people don't think they are fat. Here's the lowdown, Mr. Callahan, we know we are fat. We know we are fat when people scream at us "Fat Bitch" while trying to exercise, or when we try to find fashionable, affordable, well fitted clothes, or a comfortable seat on the bus, train or plane or we are told for every ailment we have is weight related (Even when thin people get the same fucking diseases) or we are told we are too fat to keep the same job we had for ten years or we are denied health or life insurance because we weight too much. We know when we see billboards that say "Obesity Kills" "Beat Obesity with a stick." or "Save the whales, lose the blubber, go vegetarian." 

That is what it's like to be fat. No amount of stigma, pressure, or flat out hatred will change that. Every fucking morning both and after I accepted my body I knew I was fat. Fat people aren't in denial we just don't want a lecture when we mention our weight.  

In the end the intense pressure to be thin comes from one really place, a 66 billion dollar incentive to make people hate their bodies. 

New diet drug: Bulimia.

No blog post next week as I will be away.

Here on the market is new device to make your fat issues go away. It’s called the SuckIt 3000. In order to you use this device you have to have one criterion: be fat (it doesn't matter if you are healthy or not). If you are slender the SuckIt3000 is not for you. It is socially unacceptable for a thin person to have bulimia (thin people with bulimia get interventions and Lifetime TV specials). It is however social acceptable for fat people to have bulimia. (Fat people don’t worry, instead of a Lifetime special, you get the hit TV show The Biggest Loser!)

What the SuckIt3000 does is stick a tube into your stomach (either through magic or a surgical incision) and after you eat, the tube will suck all the food vaccum cleaner and into your handy dandy vomit purse.

Then all you have to dump those contents in the toilet or nearest trash receptacle. Don't worry you won't feel humiliated. Fat people love to be shamed! 

Think I'm joking? Well last year this very device was approved for use in some EU countries and they are also looking for an approval in the US. No it’s not called the SuckIt3000 but it is in fact a surgical incision into your stomach where a tube is place. That tube sucks up food into a container which you then dump into a toilet.

Rebecca Jane Weinstein covers this horrible device in an article in XOJane. 

I imagine that this aspiration port will be a sexy new accessory with my bikini on the beach, and intimacy will be greatly enhanced by the hole in my stomach where food pours out (what a chuckle we’ll get during a romance accident). I will feel nothing but pride in my new appearance when I have to get up from the table in 20 minutes to aspirate, and everyone will be so enamored by my hot new bod that no one will blink an eye when I carry my aspiration bucket to that new trendy joint while I am wearing the perfect little black dress (which I guess I will have to remove for aspiration purposes –- but who knows, the latest runway fashions may include an aspiration-port-cut-out).  

In the end this means one thing, it's okay to be anorexic or bulimic, tortured with crazy surgeries, but only if you're fat. 

 

BMI doesn't know how healthy you are.

I can't do a blog post without covering a third study  (Actually a Systematic Review that looks at other studies) done by Katherine Flegal of the CDC that says again that people with BMI in the overweight or slightly obese (A/K/A Obesity 1, not to be confused with Obesity 2 electric boogaloo or Obesity 3: The Fat strikes back) category have better mortality outcomes then those of normal weight.  This essentially means that people with a BMI of 25-34.9 have a better chance of living longer than those whose BMI is 24.9 or less or 34.9 or more. 

I could write a rant about our horrible treatment of fat people, our constant pressure to diet, the billion dollar industry that funds it, the obsession with putting everyone in this arcane BMI category instead of looking at their actual health, or how ridiclous it would be if we told people with "normal" weight BMI to gain. 

Instead Paul Campos pretty much sums it up in New York Times op ed that I recommend you read in it's entirety. 

Now, if we were to employ the logic of our public health authorities, who treat any correlation between weight and increased mortality risk as a good reason to encourage people to try to modify their weight, we ought to be telling the 75 million American adults currently occupying the government’s “healthy weight” category to put on some pounds, so they can move into the lower risk, higher-weight categories.

In reality, of course, it would be nonsensical to tell so-called normal-weight people to try to become heavier to lower their mortality risk. 

After this study came out both it and Paul Campos' Op-Ed were attacked. I have mentioned before that any time a study comes out proving obesity was in fact responsible for Hitler, it is taking as fact without question. 

Any time a study comes out suggesting that being fat doesn't in fact step on puppies, it is always attacked as either wrong, or that while we live longer we are very sick, as this Op-Ed from David Katz points out.  Though I wouldn't call it an Op-Ed, exactly . . . it's more like a frothing at the mouth rant in which David Katz points out a lot of anecdotal evidence where he has seen a few people become thin and turn into super humans, never to have another health problem again. What he neglects to mention is all the people he didn't see. Those who never got fatty liver disease, diabetes, or any "obesity" related diseases. People have to remember that for the most part people see doctors when they are sick.  

No one questions methods used for studies proving fat is bad. No one looks to see other aspects of it for example history of dieting, history of being denied health care, stigma and stress. 

Marilyn Wann points out in her own oped piece on CNN how bias health care is towards fat people.

Weight bias has been documented among doctors, nurses, fitness instructors and other professionals on whom a fat person might need to rely for help. Last year, researchers who themselves are part of an anti-"obesity" institution (Yale's Rudd Institute) surveyed medical professionals who specialize in caring for fat people and found that they had high levels of weight bias, viewing us as "lazy, stupid, and worthless."

Why are people going crazy over news that being fat isn't the end and being thin doesn't make you healthy.

I still got 20 billion reasons. 

 

Blog post postponed until tomorrow

Blog post postponed until tomorrow

Results are still not typical

Happy New Year! Weight Watchers, Jenny Craig, Nutrisystem are all reving up their media blitz because everyone ate too much during the holidays and now it's time to start the diet. Like I mentioned in 2011 the diet doesn't start on Jan 1. But usually Jan 2-5th just enough time to get finish the holiday leftovers.

Many people will make a resolution that this will be the year they will become slim. Even though I was often dieting during eating season, I often have the same resolution. Usually because I was going to Weight Watchers meetings but not really following the program closely. (Of course 3 servings of stuffing is 1 bread exchange!) So Jan 2nd (After binge eating on New Year's leftovers), I'd be back on the program usually to fall off it a few weeks later.

I don't really believe in New Year's Resolution. Why not make the resolution right now or in four weeks ago or in March? However I've often asked myself the question on how can I be healthy without the dieting mentality. It's hard with 17 years of diet talk burned into my brain. However I put together five easy rules to try to be healthy without the diet talk.

Try
to mediate every day even for 1 minute. Take deep breaths when you can. 
Move as much as you can. Don't worry if it's not "enough". Movement can be simple things like a leisure walk, yoga, swimming, stretching or dancing around the house. 
Learn
to eat for your body. Know what foods your body can handle and which ones it can't. Never eliminate anything 100% (unless you have a food allergy.) If you're like me where dieting has ruin your intuitive eating, read Linda Bacon's Health at Every Size for tips on how to relearn intuitive eating habits. This isn't about eating less but about enjoying and savoring your food.
Go to the appropriate medical tests and yearly doctor visits. This is a drag even with my doctor who is somewhat weight neutral but it's the best way to keep track of your health. 
Don’t fall into
dieting habits. Getting healthy may not result in any weight loss. You are
doing this for health, period.

Bonus tip! - Love your body!

Happy Holidays

No blog post today. Just holiday greetings and a belief Santa needs to stay fat. He's too jolly to go on the diet/weight gain roller coaster!