Thursday, May 29, 2008

Fat is a symptom, not a disease, Part One: Medical Malpractice on a Victorian Scale

One of the most irresponsible things about the "obesity epidemic" is that weight gain and fat tissue is often treated as a disease instead of as a symptom. As such, fat patients are instructed to lose weight, sometimes by way of surgery, without any exploration as to how or why they are fat, and whether they are actually experiencing health problems as a result of it.

In the next few entries, I will discuss some of the conditions that result in weight gain, including my personal experiences with those conditions, and how medical personnel seem to have a blind spot regarding those conditions. I will also explore some hypotheses regarding why those blind spots exist, and what can be done to get past them.

It is my belief that many of the health problems attributed to fat may actually be the result of overlooked and untreated issues--issues which, as they continue to be untreated, can result in even greater weight gain. As the frustrated patient continues to be told "lose weight" in lieu of actual medical treatment, they may lose confidence in the medical establishment, not only refusing to go to the doctor when they really need to, but becoming depressed as a result of being essentially told that they are not worth the trouble of medical care due to their being fat.

This entrenched, dogmatic system of medical malpractice, seemingly based more on "common knowledge" than science, needs to be attacked, denounced, and demolished. It needs to be relegated to the status of quackery, where it belongs on the same shelf as "humours", phrenology, and hysteria--all obsolete ideas that, when in vogue, caused immense suffering and death, and often justified maltreatment of other people. Humour-balancing, often in the form of bloodletting, caused a great deal of physical damage. Hysteria diagnoses allowed men to treat women as fragile children, resulting in "treatments" that would be viewed today as sexual assault and false imprisonment. Phrenology, though less damaging, was still a quackery used to make value judgements based solely on a person's physical characteristics.

Today, the quackery of the obesity epidemic is resulting in the same abusive, damaging treatments that humour-balancing and hysteria treatment did long ago. We're given dubious medications that kill us (Fen-phen), encouraged to undergo inexcusably dangerous surgery, and treated to verbal abuse and shaming for the "crime" of taking up too much space--verbal abuse that is lauded as necessary and even beneficial. We're told that we deserve to be sick and/or dead because we are fat. We're told that we have ourselves to "blame" for any and all health, emotional, or social difficulties we have, regardless of their cause, because we are fat. Most obscene, however, is that we are promised that, if we stop being fat, all of our problems--health, social, emotional, and otherwise--will go away. We're told that, until we stop being fat, we aren't worthy of medical care, common courtesy, or even a single bite of food.

Fat is NOT the cause of all these problems. Often, a fat person's emotional and social problems are the result of unwarranted maltreatment by others. Often, a fat person's health problems are not the RESULT of their fat, but the CAUSE of it. It's a pretty damn big cultural meme we're fighting against here, but when so many people are so abominably ignorant, it doesn't make their misconceptions true by consensus. So that's what I'm here to do: Tell my stories, and hopefully change a few minds.

Next up: Part Two: Hypothyroidism


April D said...

Thank you for posting this! I was just writing to a friend last night who is having a hell of a time with doctors right now; all telling her that any troubles she is having are all due to being fat; that excess fat is producing too much estrogen and thus she is infertile (Which, btw, isn't even what she went in to discuss with said doctors).

The worst part is that she was told that reaching the magic number of 115 pounds, will make all of her problems GO AWAY. Yeah. Cause thinner folks NEVER get sick or feel like shit. Ever. Ever.

It's just another example of medical professionals deciding that one human being is not deserving of the basic right to decent medical care because of how they look. OR being too lazy to actually DO their job and find out what is wrong; using the simple "Well, you're FAT!" fall-back to brush off yet another patient. OR maybe both...

I'm looking forward to your next segments in this series! :)

Anonymous said...

What a great series already! I can't wait to read more.

After two decades (I was put on my first dr supervised diet at 8... gah) of being heavy and sick I was fianlly diagnosed (through my own research) with severe malnutrition due to Celiac disease... which likely triggered my other weight-causing issues; candida overgrowth and Hashimoto's Hypothyroidism. 80 pounds lost and I'm still fat, but not morbidly so. I'm still not comfortable and don't feel well... and now measure weight gained or lost on the scale as a measure of health, nothing else... because if my body is working well, the weight will slowly (very slowly, as is healthy and natural) drop (I could lose 60 lbs without getting out of the 'chubby' stage) and if it's not, like right now, it slowly goes up.

Like everything else, weight should be a diagnostic tool, not an indcation of a person's value, will power etc.

M said...

Lookin' forward to reading your post on hypothyroidism as I recently wrote a post about my last 12 months struggling bouncing back and forth trying to get my level back to normal. There was quite a bit of rapid weight gain and loss in the past year just due to the fluctuations of the medication. Damn it was a rough year!

liz said...

I believe that one of the underlying causes of so many doctors buying into this meme is the corporatization of health care. Back before the HMO models most healthcare is based on, doctors actually spent time getting to know their patients. Now they are often required to see 10 patients an hour and if they spend longer then the whole day gets backed up. So they take one look at a person, notice they're overweight and stop there.

Anonymous said...

I am really looking forward to this series. Your science posts are some of my favorite anywhere--you have an awesomely analytical, skeptical mind (not to mention no patience for fat-haters, which I also appreciate) yet your writing is good enough that the concepts become accessible to everyone and I'm always given something new to think about. For example, in this post I'm reminded of how often fat is just taken at face value, with no holistic consideration of why or how or when someone became fat and what that might or might not help a provider to determine about their health. So thanks for this.

TropicalChrome said...

"One of the most irresponsible things about the "obesity epidemic" is that weight gain and fat tissue is often treated as a disease instead of as a symptom."

Yes, oh yes, amen, and YES.

I am also looking forward to reading your articles because that first sentence pretty much sums up my experience with weight in both myself and others, and I thought I was the only one who thought that way. You cannot know how much it means to hear someone else say this too.

Anonymous said...

I finally got to see the documentary THIN, after Netflix had gotten ahold of it. I never realized the real extent to which this obesity panic is leading to.

I saw girls who were 80 pounds, screaming "I want to be thin! I want to be thin! I just want to be thin!" Girls who couldn't eat a cupcake for their birthday, without saying how bad they were. Sure I've heard that people behaved that way before, but once you see it you truely understand.

I think everyone in the FA movement should see the documentary THIN, to truely understand where this fatphobia is leading us, leading children. One of the girls in the ED center said she was counting calories at 5. Today that almost seems like the norm!

Jessica said...

I am so glad that you are writing about this. It is so, so important. Thank you a million times.