“Obesity-related” disease actually tracks your social status more than what size clothing you wear. In developed nations, data show, members of stigmatized groups, including those who are economically disadvantaged and people of color, are the most common victims of illnesses typically grouped under the “metabolic” umbrella. [...] With social status comes control over one’s circumstances – success at work, fostering loved ones’ well-being, being able to plan for the future, or even next week. The absence of those, no matter how punctilious our lifestyle habits, stresses our systems in disease-promoting ways. In contrast, being able to exert an influence over what matters to us is health-promoting.
This article focuses on the weight limits of air ambulances, but it’s depressing anyway. The overall message of the piece is to lose weight (which we all know works so well! And immediately!)
Now, yes, most fat people aren’t very fat; most cutoffs are 300 or 350lbs; air ambulances appear to have lower-than-typical requirements.
But what can you do? Some ideas:
- Ask your local hospital about their equipment.
- Ask you local doctor about their equipment.
- Ask local fat friends about their experiences.
- Research what is available and ask for it to be considered when new purchases are made.
- If there is an organization that fundraises for your local hospital, consider joining.
I wouldn’t expect any of these to have an immediate effect, and some are long-term commitments. These are also biased toward people who have the time, money, education, and (possibly) public speaking skills to succeed.
Finally, you can move to an area with more choices. This is definitely a long-term choice, and one that may also be impossible. But it may work for some.
Dr. Peter Attia thinks about his former patient often, the woman who came to him in the emergency room at Johns Hopkins Hospital one night seven years ago.
She was obese and suffering from a severe complication of Type 2 diabetes, a foot ulcer, which required an urgent amputation. At the time, Dr. Attia admits, he silently judged her. If she had only taken better care of her health, maybe exercised more and eaten less, he thought to himself, this never would have happened to her.
But a few months ago, in a TED talk, Dr. Attia stepped onto a stage and offered a few words to his former patient: “I hope you can forgive me.”
WHAT THE FUCK? Why should she forgive you? You’re just another judgmental asshole in a nice long line of judgmental assholes. Is it really such a stain on your self-image that someone might not worship you as the all-perfect person you want to be? Why should she spend any pity or compassion on you?
“As a doctor, I delivered the best clinical care I could, but as a human being, I let you down,” Dr. Attia, his voice breaking, said in his talk. “You didn’t need my judgment and my contempt. You needed my empathy and compassion.”
Wow. Just … wow. He thinks his “judgment and contempt” did not prevent him from delivering the best clinical care? Or is he admitting that the “best clinical care I could” might not be the best clinical care?
I still don’t see why he thinks an apology from just one doctor might MATTER at this point. Maybe it would. Maybe pigs would fly, I don’t know.
Apparently Attia’s now looking into research on whether “the precursors to diabetes cause obesity, and not the other way around“. Interesting. Did he read some genetic research on type 2 diabetes?
Dr. Attia’s insight was informed, in part, by the startling discovery a few years ago that despite paying close attention to his diet and exercising frequently, often for hours at a time, he had developed metabolic syndrome, a precursor to Type 2 diabetes. He had made all the right lifestyle choices, he thought, and yet he was overweight and on a fast track toward obesity and diabetes.
Oh for fuck’s sake. Dr Perfect is SHOCKED, SHOCKED to discover his body is not 100% under his control at all times. OMG, this is a REVELATION.
Ever use a long-handled bath brush to scrub your back?
Swap the brush for a dense sponge, and that’s basically the long-handled lotion applicator I got from Amazon. This morning I used it to put Aveeno anti-itch lotion on the itchy spot on the middle of my back. At bedtime I decided to try Benadryl cream – it’s definitely helping.
Part of me feels weird to use a lotion applicator (I can’t just reach?) Yet bath brushes – which reach the same areas – are a bath staple. Strange what seems normal sometimes.
In the meantime, the itch is subsiding and I think I can sleep.
A bit of background:
Histamine [...] causes dilatation of the blood vessels (flushing, rash, itching) and increased mucus production (runny nose, productive cough), and bronchoconstriction (wheezing, cough). Because histamine is contained in almost all body tissues, [...] it is able to cause a wide variety of symptoms.
So, allergies release histamines, and histamines causes the actual symptoms.
Well, I knew that it’s possible to be allergic to food. I even knew that if you’re allergic to sulfites you should avoid wine. But somehow I’d missed that some foods naturally contain … histamine.
There are many foods that contain histamine or cause the body to release histamine when ingested. These types of reactions are food intolerances, and are different from food allergy in that the immune system is not involved in the reaction. The symptoms, however, can be the same as a food allergy.
This also includes beer, wine and liquor.
The basic takeaway seems to be: IF you have allergies, and your allergies are getting on your case? You might want to avoid food and drink with natural histamines. There’s a long list here. A couple studies linking wine (in particular) with more symptoms in allergy sufferers were discussed here.
(Those who do not have allergies are welcome to pour a glass of wine and rejoice in the comments. Those with allergies, feel free to share other coping methods.)
- A fit fat person is usually healthier than a sedentary thin person.
- Obese people (BMI of 30 to 34.9) have no greater risk of early death than those of “normal” body size (BMI 18.5 to 24.9). Most people who fit the clinical definition of obese are in the smaller categories.
- “Normal-weight” people who think they’re fat have a lower quality of life. Why?
It distracts from the real issues:
- Weight discrimination in healthcare prevents proper diagnoses
- Health practitioners already are too likely to diagnose on body size instead of symptoms and facts
- Exercise improves health, but it often doesn’t cause weight loss. If your goal is weight loss, it’s easy to get discouraged and quit exercising.
- Fat bias prevents fat people from getting jobs, from getting raises, and from getting proper healthcare treatment. Society’s response? ”Prevent obesity!”
It’s a win for the weight cycling industry:
- Diet programs benefit from the (short-term, usually temporary) success of diets. Most people diet to lose weight and then regain. A significant subset then go on a new diet, regain, try another new diet, and so on. Someone may do Weight Watchers, then NutriSystem, then Jenny Craig, then Weight Watchers again. Who’s making money in this situation?
- When lost weight is regained, the dieter is blamed – not the diet.
- New York Times reporter Gina Kolata wrote in Ultimate Fitness: The Quest for Truth about Health and Exercise that news agencies receive hundreds of press releases a week from diet programs, authors, and researchers. Most have something to sell. Weight loss is a terrific product to sell, because it’s so often temporary.
- Ever notice how weight loss ads extolling how someone lost 40 or 50 or 60lbs will include a note “Results not typical”? There’s a reason for that.
Unfortunately, what’s good for the weight cycling industry isn’t necessarily good for patients:
- Contrary to popular belief, weight loss usually results in being less fat, not thinness.
- Being “less fat” doesn’t necessarily help.
- Dieting is a risk factor for eating disorders.
- Waiting until you lose weight before healthcare practitioners take you seriously can have long-term repercussions. Including death.
[A study], published in 2011, followed 28,800 subjects with high blood pressure aged 55 and older for 4.7 years and analyzed their sodium consumption by urinalysis. The researchers reported that the risks of heart attacks, strokes, congestive heart failure and death from heart disease increased significantly for those consuming more than 7,000 milligrams of sodium a day and for those consuming less than 3,000 milligrams of sodium a day.
Wow, it’s almost like the extreme might be the problem. Sometimes “the dose makes the poison” is worth remembering.
Forty-seven years old.
Working in software (not rocket science, but involves brains) over 20 years.
Employed and promoted by a company that prides itself on “hiring and promoting the best.”
Have been taking various meds for allergies for over 30 years.
….so why did I forget the Flonase again???
(I’m sure it has nothing to do with flonase being a nose spray, which I inhale better after my shower, vs the other morning meds which I have trained myself to take right after getting up. Nope. :P )
Petition to drop the charges against Keira Wilmot for a science experiment gone wrong and re-enroll her in school has over 36000 signatures — does it have yours?
Mammograms, it turns out, are not so great at detecting the most lethal forms of [breast cancers] a treatable phase. Aggressive tumors progress too quickly, often cropping up between mammograms. Even catching them “early,” while they are still small, can be too late: they have already metastasized. That may explain why there has been no decrease in the incidence of metastatic cancer since the introduction of screening.
At the other end of the spectrum, mammography readily finds tumors that could be equally treatable if found later by a woman or her doctor; it also finds those that are so slow-moving they might never metastasize. As improbable as it sounds, studies have suggested that about a quarter of screening-detected cancers might have gone away on their own.
17) It’s the 17th week of 2013. I think.
12) I’ve been married 12 years.
11) My car (which currently isn’t starting) is 11 years old. Probably needs a new battery.
8) I’ve interviewed eight potential coworkers recently.
5) Five loads of laundry today. This is not counting the mattress cover and comforter, which went in the dryer on high to kill dust mites.
3) I worked late 3 nights last week. (Planning not to do that this week.)
2) Two electrostatic air filters washed.
1) Sounders won their game 1-0.
What’s notable with you today?
Everything that used to be a sin is now a disease.
Variability is the law of life, and as no two faces are the same, so no two bodies are alike, and no two individuals react alike and behave alike under the abnormal conditions which we know as disease.
I have a disease, but I also have a lot of other things.
The doctor has been taught to be interested not in health but in disease.
What some call health, if purchased by perpetual anxiety about diet, isn’t much better than tedious disease.
So I can’t show you how, exactly, health care is a basic human right. But what I can argue is that no one should have to die of a disease that is treatable.
Had a follow-up appointment with the allergist last week.
It was nice to confirm that needing to use albuterol prior to aerobic exercise is expected (exercise is an asthma trigger, especially if combined with cold air). Albuterol is also my “rescue” med, which I use when my asthma symptoms worsen. I haven’t been needing to use it as a rescue med for weeks, which is great.
I also agreed to start immunotherapy shots for my allergic triggers (dust mites, grass, pet dander). It’ll take a few years, but hopefully it will reduce my allergic triggers in the long term.
1) I am sooo looking forward to tomorrow morning, when Mark Reads will post the second-to-last chapter of Deadline. Mark Reads reviews books a chapter at a time, progressing through books every other weekday, and it’s been building to this OMG HUGE second-to-last chapter for weeks. (Need I say “spoilers”?) Some of the books he’s done this with in the past are the Harry Potter books, The Hobbit, The Lord of the Rings, and The Hunger Games. Deadline is the middle book of the Newsflesh trilogy & Mark’s reading the whole thing, starting with the first chapter of Feed here.
2) I got myself a Fitbit Zip to help me be more consistently active — I use it as a pedometer that does built-in recordkeeping, so I can get a sense of how active I am in general, not just a single day. Since I got it I’ve found myself at work focusing deeply for one to two hours and then getting up to walk and get water or coffee or tea or something. I’d quit feeling guilty about it because I found that a brief break to walk and stretch lets me focus better afterward. This article helps me rationalize it more ;)
3) A year ago today I signed my father’s hospice paperwork as his medical power of attorney. The anniversary was a bit freaky this week. At the moment I’m at peace with it all, but I know my reactions will likely continue to change.
4) I’ve been posting on fat discrimination at http://fatdiscrimination.tumblr.com. It’s not a subject I want to dive into a lot, so posts are somewhat sporadic.
- Advair inhaler, twice daily.
- Spirivia inhaler, once daily.
- Flonase nose spray, once daily.
- Singulair & antihistamine, once daily.
- Rescue inhaler, 2 puffs before exercise or as needed.
- Vacuum several times a week.
- Weekly wipe down surfaces in bedroom.
- Weekly wash sheets, comforter cover and pillowcases in hot water to kill dust mites. (Dust mites is a major allergy for me – bigger reaction on a scratch test than the straight histamine.)
- Weekly spin comforter and mattress cover in hot dryer to kill dust mites.
- Mattress cover is washed monthly; pillows & mattress have dust mite proof covers.
….and we also dust more often in other rooms, but the bedroom gets the most attention since I am physically there more than anywhere else.
But of course, “choosing” to be fat shows I hate the idea of improving my quality of life & I want to be sick.
I stopped eating in the eighth grade.
People complimented me on how much weight I was losing, how much prettier I looked, how much better I was.
They didn’t know something was wrong until I started passing out. And when my eating disorder finally came to light, it was largely seen as me going through a phase to be popular or noticed, much like with my cutting and suicide attempts.
Because, you know, depression and suicide and self-harm and eating disorders are only a phase.
Fat Acceptance proponents range from those who think that the link between fat and “obesity-related” diseases is overhyped and not looked at critically enough, to those who flat-out say that fat does not cause any diseases. (One problem with the latter statement is that just as correlation does not prove causation, it doesn’t disprove causation either; saying we don’t know for sure that fat causes* something does not mean that we know for sure it doesn’t cause something.)
You may guess from her parenthetical, and my including the parenthetical here, that I happen to agree that the link between fat and health is overhyped and not looked at critically enough. I also think that links between fat and health are questionable at lower sizes of fat (which are most fat people).
However: I do not think those risks make weight loss any easier or any more likely to last. There’s no proof that maintaining weight loss improves health in general (unlike quitting smoking or starting to exercise). And, finally, the pursuit of health is not an obligation we owe to the world for existing.
[Feel free to skip if you don't want to think about dieting right now.]
It’s January and there is the usual plethora of diet commercials extolling weight loss. Google “dieting” and up comes Special K’s “Healthy Eating Plan”!
That said, it is a bit refreshing to see someone write:
As a lifelong dieter, let me tell you from experience: A diet need have nothing to do with “eating healthy.”
[...] It’s possible to lose weight by eating more healthily. But losing weight and eating more healthily can also be two totally different goals.
The cultural conflation of “eating healthy” and “dieting” has a lot of built-in assumptions.
- Fat people are fat because they overeat.
- Thin people are assumed to eat “healthy”.
- Fat people are expected to diet, which leads to weight cycling.
- Cultural expectations to lose weight causes pressure.
- After a few years (decades?) of being burned by diets, folks end up rebelling against the pressure.
There’s certainly more (and I haven’t even gotten into all the debate over what “healthy eating” means).
One result of the end-of-year crunch at work is that I haven’t been eating lunch regularly. I’m going to work on permission to eat what I want, and eating at regular intervals. But I am still avoiding diet commercials.