"Metabolic mayhem" vs. the American obsession with weight

Warning #1:  Long post.

Warning #2:  This post is full of what some call TMI, or Too Much Information, which seems to refer to topics not always considered appropriate for public discussion--because I think it's high time that we started talking publicly about these things.

First of all, let me explain the term "metabolic mayhem," which I've been using with my friends for years--I believe I coined that term, but I wouldn't swear to it.  When I use the term, I'm referring to just about any problem that affects digestion and/or nutrient absorption.  It can affect organs and glands as disparate as the intestines and the thyroid--there's been some talk about a "brain-gut connection," as well.  It can include problems as relatively minor as occasional acid reflux and as major, and potentially life-threatening, as a peanut allergy, diabetes, Crohn's or colitis.

Here's a joke that I've often shared with friends:  "The fastest way to lose weight is to get sick."  The problem with that joke is not only that the joke itself is less funny than sick, but that it's indicative of  an attitude that's typical among many Americans, and, I think, among many others raised within "western culture"--the notion that thinness is more important than wellness.

When I first started having problems with my digestive system and was trying to find a "treatment" diet (as opposed to a weight-loss diet), I remember reading a distressing tale about a woman who was in much worse shape than I am.  She would eat very little at work, and would turn down almost all invitations, because all she could do at night was go home and eat and then spend most of the evening on the toilet--her body was so bad at absorbing food that nothing would stay in.  Yet her co-workers complimented her on her slim figure.  They had no idea that she wasn't thin by choice, but, rather, her size was the result of a very serous health problem.

Here's another thought regarding weight:  Which comes first, the "medical" illness or the psychological one?  Is it just me, or is it hard to get a straight answer regarding whether eating disorders such as anorexia nervosa, bulima, or binge eating have an emotional cause or a physical one?  (Some folks have described eating disorders as a brain disease.)  I've read reports of children as young as seven or so going on diets because they already think that they're too fat.  Is the obsession with weight a major cause or partial cause of these types of eating disorders?

No matter what the cause(s), eating disorders are no joking matter.  They can result in overall health problems, depression, and even suicide.  😢

 

And what if you happen to have an opposite type of eating disorder?  

This article is accessible to all, and I recommend it--Everything You Know About Obesity Is Wrong.

 

Here's an excerpt:

 

"For 60 years, doctors and researchers have known two things that could have improved, or even saved, millions of lives. The first is that diets do not work. Not just paleo or Atkins or Weight Watchers or Goop, but all diets. Since 1959, research has shown that 95 to 98 percent of attempts to lose weight fail and that two-thirds of dieters gain back more than they lost. The reasons are biological and irreversible. As early as 1969, research showed that losing just 3 percent of your body weight resulted in a 17 percent slowdown in your metabolism—a body-wide starvation response that blasts you with hunger hormones and drops your internal temperature until you rise back to your highest weight. Keeping weight off means fighting your body’s energy-regulation system and battling hunger all day, every day, for the rest of your life.

The second big lesson the medical establishment has learned and rejected over and over again is that weight and health are not perfect synonyms. Yes, nearly every population-level study finds that fat people have worse cardiovascular health than thin people. But individuals are not averages: Studies have found that anywhere from one-third to three-quarters of people classified as obese are metabolically healthy. They show no signs of elevated blood pressure, insulin resistance or high cholesterol. Meanwhile, about a quarter of non-overweight people are what epidemiologists call “the lean unhealthy.” A 2016 study that followed participants for an average of 19 years found that unfit skinny people were twice as likely to get diabetes as fit fat people. Habits, no matter your size, are what really matter. Dozens of indicators, from vegetable consumption to regular exercise to grip strength, provide a better snapshot of someone’s health than looking at her from across a room.

The terrible irony is that for 60 years, we’ve approached the obesity epidemic like a fad dieter: If we just try the exact same thing one more time, we'll get a different result. And so it’s time for a paradigm shift. We’re not going to become a skinnier country. But we still have a chance to become a healthier one."

 

Yet we discriminate against people who are considered heavier than "normal" in both our attitudes--disrespect and/or disdain, for example--and our actions.  Some folks don't wish to spend time with and/or pay attention to people who are "overweight."  Even health care is affected by a poor attitude toward people with "weight issues:"

"Ask almost any fat person about her interactions with the health care system and you will hear a story. . . .: rolled eyes, skeptical questions, treatments denied or delayed or revoked. Doctors are supposed to be trusted authorities, a patient’s primary gateway to healing. But for fat people, they are a source of unique and persistent trauma. No matter what you go in for or how much you’re hurting, the first thing you will be told is that it would all get better if you could just put down the Cheetos."

 

The results of discrimination against fat people can be literally deadly:

 

"“It borders on medical malpractice,” says Andrew (not his real name), a consultant and musician who has been large his whole life. A few years ago, on a routine visit, Andrew’s doctor weighed him, announced that he was “dangerously overweight” and told him to diet and exercise, offering no further specifics. Should he go on a low-fat diet? Low-carb? Become a vegetarian? Should he do Crossfit? Yoga? Should he buy a f_ _ _ing ThighMaster?

“She didn't even ask me what I was already doing for exercise,” he says. “At the time, I was training for serious winter mountaineering trips, hiking every weekend and going to the gym four times a week. Instead of a conversation, I got a sound bite. It felt like shaming me was the entire purpose.”

All of this makes higher-weight patients more likely to avoid doctors. Three separate studies have found that fat women are more likely to die from breast and cervical cancers than non-fat women, a result partially attributed to their reluctance to see doctors and get screenings. Erin Harrop, a researcher at the University of Washington, studies higher-weight women with anorexia, who, contrary to the size-zero stereotype of most media depictions, are twice as likely to report vomiting, using laxatives and abusing diet pills. Thin women, Harrop discovered, take around three years to get into treatment, while her participants spent an average of 13 and a half years waiting for their disorders to be addressed."

 

See also the Body Manifesto video series, by Lindo Bacon, PhD, recommended by Eliana Light (see below).

For those of you who have access to Facebook, I recommend that you read this eating disorder & mental health awareness post by Kerry Marie Conboy, and see this post and music video by Eliana Light on being kind to oneself and others about weight.

 

What, exactly, are we doing to our bodies and souls, and those of our family and friends, by obsessing over weight?  Does this really make us healthier people, or does it just leave us hurt, upset, and/or depressed, and perhaps avoiding the health-care system to our own detriment?  

Why can't we just be comfortable with, and happily enjoy, whatever body we have?

And how can health-care professionals help us stay healthy no matter what we weigh?

 

The floor is open.  I'd particularly love to read comments by health-care professionals and/or those affected, directly or indirectly, by the battle between "metabolic mayhem" and the American obsession with weight.