Saturday, May 04, 2013

Weighty Matters

I sometimes make surprisingly long posts in other people's blogs. I responded to a posting and some comments in the blog The Skeptical Scalpel: "Institute of Medicine: Obesity is not caused by lack of willpower" and thought I'd reprint them here. The quote that set me off was not made by the blogger, but was made by one of the commenters.
[[Fall 2012]]

"We are way too accepting of the obese. We should be sure to mock and scorn the obese more often. We should make fun of those who don't exercise or who frequent McDonald's. "

Harassment is never helpful (unless you're pulling a "Modest Proposal" here and I'm missing it).

I've been thin, fat, obese, morbidly obese, obese and now am merely fat. I've lost 65 pounds over the last 16 years, and have about 45 more pounds to go to be roughly average. I was harassed constantly about my weight in school, and, trust me, it did not help make me a thin person. It made me really pissed off. On the other hand, it did train me that most people's opinions do not matter. [[small clarification - I wrote most of this in the fall of 2012. I regained the 20 pounds after writing this.]]

I have a mixed viewpoint on the issue of obesity and health.

Genetics do matter, but they are not necessarily destiny. I come from a long line of fat people. Carbs and proteins taste great to me. While I've learned to eat some vegetables and fruits, I never, ever crave them, as much as I should. I'm still learning.

No matter what your weight is, you have to accept yourself, be reasonably active, and eat sensibly. There are a lot of self-hating thin and fat people out there.

Gym classes in school need to be dramatically rethought. When I was in school in the '60s and '70s, they focused on sports. Some of us were and have always been wretched at sports. They ought to be focused more on activities and health. They should expose kids to sports, but if the kids happier walking the track than trying to hit a baseball, that should be considered an acceptable gym activity.

The interaction of obesity and the medical community is, frankly, awkward. During the 90s, I remember being shocked by being asked "do you mind if we weigh you?" While people need to be respected by clinicians no matter what their weight, information like their weight, height, cholesterol, blood sugar (and so on) need to be recorded. Fat people should not be harassed, but they do need to be reminded about good eating habits and activity no matter what their weight is.

I think the thing that made me finally start to lose weight was the introduction of gastric bypass. While I eat less than I used to and do exercise more, I love a good meal. I still find eating very pleasurable, despite its potential dangers. I was at the point where gastric bypass was an option, and I knew I didn't want to have eating be that unpleasant.

I opted to start walking. I just did little things at first, like parking across a parking lot from my work or a store. Right now, I'm unemployed and am walking 3-4 miles a day.

I think one of the other big problems with attitudes towards obesity and dieting is this idea that loosing weight can be easy and fast. It isn't. Relearning how to eat is hard. But, the more we can non-medicalize loosing weight (focusing on diet and exercise rather than drugs and surgery), but better we all be in the long run.

I don't think there is "a" solution. Obesity/anorexia are tricky conditions and relate to upbringing, education, community planning, marketing...there are many unrelated pieces to a person's size. Medical personnel need to be respectful (and generally are), but need to have good information about nutrition available. And I understand nutrition isn't generally taught in med school.

[[Spring 2013]]

I don't really agree with the anonymous poster who said "it has to do with hunger." It has to do with our REACTIONS to hunger.

At some times of the day (morning), if I'm hungry I'll have a glass of water and feel fine with it. At other times of the day (afternoon), I need something to eat. It used to be junk food...and sometimes, it still is. But, generally, my afternoon snack is hummus and crackers or some peanuts.

Last year, I lost 20 pounds, but most of that was due to illness. However, in the fall, I went off of one medication, and noticed I was really craving carbs badly, which meant I was again eating more carbs. Also, it seemed like I was gaining weight no matter what I did (I walked 90 miles one month last fall and still gained 5 pounds that month). So I gained back the 20 pounds in 5 months.

I realized the obvious thing (beyond I was eating more than I should) - I'm now through menopause, so of course I'm going to gain weight a little more easily. I am being more careful again, am not craving carbs quite so much, and am back to really slow weight loss.

For many people, maintaining an average weight is easy. You're VERY lucky. For many of us, it's hard. To blame JUST the individual or JUST the environment is wrong-headed - weight is a very awkward combination of personal and societal.

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