Fat

I've been contemplating weight these last few days. Hell, I've been contemplating weight this last half century. For most of that time, I was obsessed with the scale and what value it judged me to have in the world. The last five or six years, I've not given it that power over me; have thrown out my bathroom scale and only get on the one in the doctor's office once a year and with my back to the numbers. I've trained them not to comment on my weight at all -- don't even tell me if it's gone down. I don't react well to knowing and I've decided not to allow it to consume my life any longer.

Recently, there have been a few posts in the blogs I read that have directed my thoughts to this subject, not in the obsessed, "how am I ever going to get thin enough" way, but back to the realization of what this preoccupation with size does to people.

On the 8th, my friend Deja Pseu over at Dilettante's Progress, posted Background Noise about what it is like to live with a weight problem.

I can't remember a time in my life when I didn't want to be thinner. The effect of this has been to generate a constant kind of background brain static that never fully goes away, a dog-whistle whine of constant dissatisfaction. Even when I'd lost weight to the point where I was quite thin, the static remained. "Just another 5 pounds" was the seashell noise in my ear.

Sandy Szwarc at Junkfood Science has two posts that became part of this pondering. The first is News Too Troubling To Stomach which concerns the degree to which our culture's hatred of fat people results in a willingness to hurt children:

. . .exploiting and mocking fat children for entertainment on reality show fat camps. . .
***. . .an upcoming show featuring Paris Hilton and Nicole Richie as weight loss camp counselors. But there’s more... ***. . . administer enemas to the fat teens, outside, in front of television cameras. These starlets were “more than happy” to talk to the press about what they did. Both they and the show’s producers appeared oblivious to the unimaginable degrees of humiliation they subjected these fat kids to, let alone how they endangered their health. ***Now, as far as this fat camp reality show and others like it, I don’t know why lawyers, size acceptance and civil rights organizations aren’t all over these things (substitute black or crippled children for the fat children and the public outcries would be swift and loud); why parents or other adults would even consider allowing their children to be victimized and ridiculed in this way; or why anyone would watch. And that reveals the most troubling aspect of all.

The second is News A Woman Can Use in which Sandy takes a look at older women and weight.

The researchers concluded that the lowest risks for older woman was to be fatter than the current government recommended BMIs. Our chances for living longer and healthier improve with some fat on our bones. The researchers specifically said that the National Heart, Lung, and Blood Institute (NHLBI) guidelines, which recommend weight management of “overweight,” were inappropriate in older women because those were the sizes where women have the lowest rates of mortality. In other words, following government guidelines would increase their risks for dying*. ***. . .researchers at the University of California, San Francisco, found that except for smoking none of the lifestyle and risk factors popularly believed to be important actually made a difference in how long we live, and that obesity was associated with a 30% lower mortality. And for those who develop heart failure, every 5 BMI units higher lowered the risk of dying by 10%. The Cardiovascular Health Study of 5,200 older men and women, recently published in the Journal of the American Geriatric Society, again found that body mass index was inversely related to mortality. ***. . .it bears repeating because of the exaggerated fears about obesity, that based on weight alone, a woman is no more likely to die at a BMI of 50 (about 310 pounds) as at a BMI of 35, and that the most extremely "morbidly obese" women still have a longer life expectancy than normal weight men. Our figures need not be our worry.

* Emphasis added.

Last Thursday, Julie posted Fat, a look at the recent PBS special and her thoughts about it.

Several years ago, in the hospital after suffering a heart attack, my bony tiny grandmother asked her bony tiny sister to check her chart, to see how much weight she had lost while flat on her back. When told she had lost a pound and a half, she was disappointed, she had hoped for more, that she would have been able to ‘do better’. ***It’s an issue that is haunting so many people every day (like the oatmeal commercial, where the people have their scales chained to their ankles while Willy Nelson sings, “You are always on my mind…”)

Since then, I have watched the special (I had recorded it) and the things I noticed were, in the section on weight loss surgery, I didn't see much indication of the dangers of this surgery. It has very high mortality rates (I have heard both 1 in 100 for on the table and 1 in 50 for within 90 days), nutrient absorption is reduced for the rest of the person's life, leading to nutritional diseases, and weight rebound is just the same as for diets.** And, in the discussion at the end among the medical personnel, they mentioned that dieting didn't work, and then proceeded to give what was good advice for living a healthy life in such a way as to make it sound like weight loss advice. In a culture as saturated with fat phobia and diet messages as this one, I would have reiterated that these suggestions were for optimum health and that there is no way to lose weight permanently that works for more than two percent of the population. I did fall in love with the idea of being "a free-range fat woman" as mentioned by Pat Lyons.

And this special has also been a subject over on Big Fat Blog, where in discussion, one commenter stated that obesity was the one subject on which Michael Moore would not be taken seriously.

And that is how I feel about explaining to my agency head why we shouldn't pass out weight information along with the alcohol and smoking information at health fairs. It would be easier to tell him about the fat producing effects of dieting if I were thin, somehow. Somehow, it feels like an excuse when I try to tell people about all the research that emphasizes how dangerous it is to diet. There is a part of me that knows that, having been on around 35 diets and weighing more than twice what I did when I was put on my first one, I am living proof that they don't work. But, who gives credence to what a fat woman says about weight?

I remember one day about five years ago, I got out and about early and had an hour walk under my belt by breakfast time. I headed down to McDonald's, feeling alive and good and clear headed and centered and all of the things I feel when I get a good walk. On the way, I passed the garbage truck as the workers finished emptying several cans and stopped to thank them for the good work they were doing, remarking that it is nice that someone comes and carts this stuff away (I'm aware of this, because I have lived where no one does and you have to do it yourself). A block or so further on, a FedEx truck stopped near me and I opened the building door for the burdened driver. I saw my reflection in a shop window and liked the chartreuse and turquoise pants suit I was wearing, as well as the Tweetie Bird applique on my purse and the fact that I had a box of Edward Gorey Christmas cards to address in that bag. I was feeling on top of the world, until I went into McDonald's and remembered that I don't fit into the booths; I have to sit at a table with chairs that can be pulled out. And all day long, that one fact defined me. I wasn't the well dressed woman in the gorgeous pants suit or the polite woman who helped the FedEx man and thanked the garbage man or the woman with the outre sense of humor who sent Edward Gorey Christmas cards or even the playful woman who had Tweetie Bird on her purse. I was the fat woman who had to sit at the special table in McDonald's.

** Survivors are in for months of difficult recovery with complications such as ulcers, hernias, vomiting, and internal bleeding. The mortality rate of follow-up surgery (and a surprisingly high number of patients have to have at least one follow-up surgery) is even higher than for the original surgery. And, one thing they don't ever seem to talk about before hand -- the patient then has to live on a strict diet for the rest of their lives and may gain back more than they lost anyway. Then there is "predictive malabsorption" (a name which more than implies that the condition is predicted!) a side-effect which stops the body from absorbing crucial nutrients. Post operative patients are prone the diseases of malnutrition! One of which is brain damage. And may have to give up certain foods for the rest of their lives. Patients who get weight loss surgery are people who have had trouble dieting -- and now they have to diet more stringently than they ever had to before.