Things Worth Reading

March 20, 2009

Things Worth Reading

Do you know your upper arm size in centimeters? Well-Rounded Mama has a great post on how the wrong blood-pressure-cuff size can cause misdiagnosis and over- or under-treatment. (Mine is 48.)

Margaret Cho’s “diet” where you eat what you want, you don’t have to eat anything you don’t want, and you can buy clothes that fit you now.

Body dissatisfaction increases risk of suicide in teenage girls. Not being fat, mind, but thinking they’re fat. Right.

The FDA has expanded it’s warning of weight-loss products that are more unsafe than normal weight-loss products.

Branwyn has a great post on self-care and how fat people are taught not to take care of their own needs.

Several folks have posted about the Canadian press‘ discovery that many fat people “are not sick at all” and that weight loss should not be attempted unless there is an actual medical need, not just trying to fit a certain weight category for insurance/employment/vanity purposes. I agree this is a good message to get out in the press. But I also doubt that Dr. Sharma’s view of “benign/stage 0 obesity” includes someone my size. After all, I weigh 400lbs, I have sleep apnea (same as my thin father) which is “completely reversible with weight loss”, it says so right in the gastric bypass marketing literature Dr. Sharma’s website. So while I find this line of reasoning interesting…I do take it with a heaping (watch that blood pressure!) serving of salt.

I has mistakenly thought Dr Sharma’s categorized arthritis as being reversible with weight loss. On re-reading I found this was not the case and removed it.

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Living 400lbs

I blog about what it’s like to be live life at about 400lbs. :)

7 responses to “Things Worth Reading”

Patsy Nevins

March 21, 2009 at 3:05 am

Why do I have a feeling that dear Dr. Sharma’s idea is that maybe people who are, say, 20 or 25 pounds heavier than model-thin but who have perfect ‘numbers’, who actually a perfectly normal weight anyway, should not be forced to diet, but that the rest of us should be? Virtually every time something like this comes out & a lot of people around the fatosphere are jumping up & down & applauding about how broad-minded & understanding these doctors are & how much they ‘get it’, or that it is at least “a baby step in the right direction, further investigation usually says….not so much. I am about 5’6” & I imagine that Dr. Sharma would have said my usual, non-dieting teenage weight of around 155 would have been “benign/stage0 obesity” (since the idiot who took my medical history at the beginning of my second pregnancy labeled me ‘obese’ on my chart for ‘risks’ at a weight of 156 pounds…I had been dieting before I discovered I was pregnant, my last diet ever, even though the same idiot tried to persuade me to diet after my son’s birth, while I was nursing), but that, now, since I weigh around 200, he would feel I should do something about my weight, despite the fact that I am pushing 60 & have always had few health problems, that weight loss at my age increases mortality risks, or the fact that I have had many fat relatives who lived well into their 80’s & 90’s & now have two fat brothers who are in the 70’s. No, I am sure he would not find my ‘obesity’ to be ‘benign.’

I would not be too eager to give much credence to the word of someone who believes that sleep apnea & arthritis (& probably diabetes, since many believe that as well) are completely reversible with weight loss & who is promoting WLS on his website. As much as we may want to believe otherwise, this guy is not on our side.

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wellroundedtype2

March 21, 2009 at 7:42 am

I read Dr. Sharma’s blog regularly, and I don’t think he’s on any particular side. For a self-declared obesity doctor, he’s more compassionate than I would have thought. But people go to see him specifically for weight loss — not the “fat well” or people who don’t ascribe their health to their weight.

So, he sees only fat patients, and he’s able to say to some of them — yes, you may be at higher risk of some conditions, but as your doctor, the best thing I can recommend is for you to be active and eat well and try to avoid gaining more weight.

The rest are coming to him specifically for weight loss.

He’s advocating that for those fat people he doesn’t see, primary care docs take the same approach — if you see a fat person who looks healthy, don’t suggest that they diet. That may not seem radical — but it puts him in opposition to many who think that everyone with a BMI over 25 needs to be put on a diet.

He isn’t a perfect fat acceptance spokesperson, but he’s saying things that aren’t being said much outside of fat acceptance circles. His vocation is to treat fat people — and he believes that things like surgery and drugs are appropriate for some, but not all. Those of us around here might believe that surgery and drugs aren’t appropriate for anyone, but there is a difference between the people out there who are saying that anyone with a BMI of 30 or over is a good candidate for weight loss surgery and someone who says it’s a last resort option. IMHO, Dr. Sharma is a resonable voice in an unreasonable discussion.

He really grapples with what it means to say that some fat people won’t benefit from their fatness being “treated,” here:
http://www.drsharma.ca/obesity-to-lose-or-not-to-lose.html
For someone whose specialty it is to treat fat people who come to him wanting to lose weight, he’s more reasonable than I might otherwise expect.

To me, the best doctor (and I have doctors who seem to take this approach) is to see the patient in front of them, their history, and who they are, what they want to do in their lives, and provide them with the best council on what options there are to treat their health issues and manage their conditions.

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1. living400lbs
  
  March 24, 2009 at 10:16 pm
  
  I agree he’s making some good points, and that he’s pointing out that weight loss is NOT easy and does NOT fix everything. Also that he emphasizes looking at non-weight-related causes for and non-weight-loss treatments for diabetes, hypertension, and so forth.
  
  I also realize that “sleep apnea is caused by being fat just lose weight and it’ll go away” is one of my pet peeves because my father has had sleep apnea my entire life. Dad had loud, interrupted snoring/breathing when he was an underweight teen, when he was a “normal” weight adult, and now that he’s a slightly overweight senior. I’ve had a sleep specialist tell me weight loss will probably NOT fix my apnea because my airway is small – and that even surgery to open my airway will not necessarily “fix” it. So anyone who writes that sleep apnea is “completely reversible with weight loss” is going to hit my “This guy’s a QUACK!” buzzer in a way that it doesn’t for others. Does that make sense?
  
  Reply
  1. Dusky Flower
    
    February 6, 2013 at 6:35 pm
    
    Hits mine too- my dad lost weight after being treated for sleep apnea, and I think he said something about it being the CAUSE of the weight gain. His knee problems stopped too, because with good rest they healed faster. Funny how these things work…
    
    Reply
wellroundedtype2

March 21, 2009 at 8:04 am

A couple more posts from Dr. Sharma that I think are good, and show where he is coming from (not fat acceptance, but some middle ground):
http://www.drsharma.ca/when-will-health-professionals-understand-obesity.html
http://www.drsharma.ca/unrealistic-weight-loss-expectations-guarantee-disappointment.html

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Regina530

March 21, 2009 at 3:49 pm

I applaud Dr Sharma’s mindset in the articles you linked here. There are not enough doctors treating mainstream America who are educated enough in the reality of obesity treatment and the effects of dieting on the body (which just boggles my mind).

Countless times I have been told by medical doctors that I need to “eat less and exercise more” for weight loss. NEVER has any doctor I’ve seen actually run the numbers for me in regards to total calories eaten and burned….they just prattle on about eating more fruits and vegetables and participating in cardiovascular exercise for 30 minutes 3-5 times a day…etc.

NEVER EVER have they discussed my particular limitations or challenges (back pain, the shakes and headaches from missing meals, fatigue, mild asthma, overwhelming feelings of hunger, etc.) that accompany every diet I have ever tried in my life. It’s always a “one size fits all” plan that has failed me time and time again.

Most doctors will tell you up front you need to lose “X lbs.” in intervals of 1-2 lbs a week. When I explain to them that my body never, ever loses weight that regularly ( I lose nothing for weeks at a time, then drop 5-7 lbs., then nothing again..and so on) my words are met with sneers and disbelief, with no solution or offers for testing. It leaves me believing that I’m doing it wrong, once again, and since I don’t seem to have any say over how my body drops pounds, helplessness sets in.

Additionally, the doctor never discusses plateaus, the body’s natural response to dieting, injury prevention, or alternative methods (other than weight loss surgery of course) to help me achieve weight loss. Sure, a dietitian, nutritionist, or physical therapist can offer insight into these things, but why can’t the doctor address these things up front, since he or she’s just scared the hell out of me with the “OMG U NEED 2 LOSE WEIGHT RIGHT NOW OR U WILL DIE!!!” lecture?

Though Dr Sharma may still have a long way to go in mainstreaming medicine for obese patients, I find it refreshing to hear a medical professional discuss the REALITY of dieting and weight loss, not just pat formulas that have failed over and over and over. Much of Dr Sharma’s approach is at least a step towards reality for me.

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Patsy Nevins

March 22, 2009 at 3:33 am

It’s a small step, but I think more acceptable for those fat people who are still themselves of the mindset that they need to lose weight, that fat is killing them, &/or that they MUST eat a lot, eat more than they think they do, yadda, yadda. Then some of these doctors go off on some tangent about ‘thin people who eat themselves fat’ as opposed to genetically fat people, when study after study has shown not only that fat people eat no more or differently than thin people, but that it is virtually impossible for naturally thin people to ‘eat themselves fat’, that they generally gain little weight, even in supervised studies where they are trying to do so, & lose it easily. So we still, with Dr. Sharma & others of his ilk, are being treated to the belief that there are ‘good fat people’ & ‘bad fat people’ & that there is a place in this world for diet drugs & WLS, etc. And I would agree with the owner of this blog that it is extremely unlikely that she or anyone else her size would be advised to accept her body as it is & live her life without trying to alter her body.

Of course, I must also admit that I have been involved in fat acceptance/liberation & the non-dieting lifestyle for over 30 years now, & I have seen so many of these people come & go, publish books, be proclaimed darlings of the fat acceptance movements as people who are broad-minded & accepting, only to read them carefully & find all the old ‘thinner is better & if you just do this, you will lose weight’ mindset, followed, as in the case of Glenn Gaesser, for instance, by writing diet books. However much some may welcome Dr. Sharma’s very equivocal acceptance of SOME degree of fat in SOME people, the inescapable fact is that he earns his living by trying to get people to lose weight. I for one would never lose sight of that fact.

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