Living ~400lbs

Well, now, let’s think about this. Besides the negative affects of weight bias, besides the negative effects of the resulting stress, besides the fact that trying to lose weight often results in gaining more, there’s this little gem:

[I]n one 1960s test, when hospital patients were given sugar water and told it would make them vomit, 80% of them did. – WSJ

This is called a “Nocebo result“: The patients’ belief causes the problem they expect to have.  (House fans may recall an episode about it.)

Patients with asthma were divided into two groups. One was given a bronchoconstrictor, which ordinarily makes asthma symptoms worse, and told that it was a bronchodilator, which normally improves the symptoms. This placebo suggestion reduced their discomfort by nearly 50%. The second group was given a bronchodilator and told it was a bronchoconstrictor. The nocebo suggestion reduced the drug’s effectiveness by nearly 50%. – Harvard Health Letter

This is not a psychiatric disorder.  “It’s the way the mind works,” cites an expert in the WSJ.  The WSJ’s article focuses on whether reading about a drug’s possible side effects can lead to a nocebo result: If you are told that a drug can cause headache, and you get a headache while taking it, is it the drug, nocebo, or just a headache you’d have had anyway?

I can’t help but wonder: If a fat person is told she is unhealthy over and over, could that lead to a Nocebo result?

A possible example of nocebo effect on coronary disease has been teased out of the famous Framingham study (a massive longitudinal study that began in 1948). Elaine Eaker and her colleagues found that women who said they were more likely than other women their age to develop heart disease were in fact twice as likely (over a 20-year period) to experience myocardial infarction or coronary death, even when the results were controlled for variables like smoking, high blood pressure and high cholesterol. – Salon

So, what to do?  Well, I don’t know exactly what will work.  But I have some ideas.

• Be skeptical of anti-fat hysteria.
• Do things that you enjoy that improve your own health.  Vesta at Big Fat Delicious enjoys walking.  I like to do yoga and lift weights.
• When you do deal with doctors, become involved in your own health.  Ask questions. Don’t take “Well, you’re fat” as a diagnosis.

Other thoughts?