The Cheese Grates It: Medical Size Shaming Harms, Does Not Help Patients

This post is in response to an article by Dr. Jennifer Gaudiani.

http://theprojectheal.org/binge-eating-disorder-stigma/#comment-254

I wish I could find a doctor in the Denver area who has a weight-neutral philosophy when dealing with patients.

I have multiple endocrine problems. Following menopause, my thyroid, which was a major factor in my weight gain, started doing something new. This, as well as properly treating my diabetes, has led to weight loss for which I wasn't trying. However, I am still a big person.

Thyroid medication tends to cause blood pressure elevation (as you know) and I probably have idiopathic hypertension anyway, as it runs in my family. I have been out of one of my BP meds for three weeks. The pharmacy claims that the doctor won't authorize it, the doctor claims they have never been contacted by the pharmacy.

I went to the doctor to try and get this resolved.

His solution was "if you'd just lose 5 pounds..."

I said I'd lost more than 50 pounds in the past couple of years without trying, and my weight has been all over the place my entire life."

I was distraught and disgusted at not being listened to. I did something which I hadn't done in a long time: I binged on a couple of boxes of crackers and a pint of ice cream. Great for my diabetes, I know. I couldn't make myself care.

This is why I really need a weight neutral practitioner. This kind of shit undoes the good that I've tried to do for the sake of my diabetes. I'm not perfect, but I try not to binge. However, I'm also not trying to lose weight. I can't go back on the self-loathing yo-yo dieting roller coaster.

People deserve to be treated with compassion and dignity regardless of their size.

The Cheese Hath Grated It

The Cheese Grates It: Freaky Fabulous

This picture appeared in a group that I (sometimes wonder why I'm part of) on Facebook with the caption "say one word." 

The expectation was that the words said would be something mean.

I said more than one word.

This is what I said.

Fabulous! If that's how he likes to roll, it doesn't mean everyone else has to. Why be mean? He may not have the money to afford really nice things, so he makes his style with what he has. Sometimes the people we think look "weird" are the nicest people, where the ones who look all "buttoned down" are uptight jerks.

A lot of the people in this group are "devout Christians."

I've discovered that "devout Christians" are often the most mean-spirited, unaccepting lot, which is why I tend to avoid them.

A society that bases a person's worth on an arbitrarily decided "acceptable" appearance tends to be an unhealthy society.

The Cheese Hath Grated It

This is our Tao

This is our Tao.

We do not need temples.

We do not need organised religion.

We do not need gurus, priests, mullahs, ayatollahs, lamas or popes.

We only need love, love and compassion.

This is our philosophy.

This is our Tao.

The Cheese Grates It: Correlation is Still Not Causation

Photo copyright Molly Adams

This is a response to an article by Dr. Heather Metcalf.

There are certain medical conditions which may be correlated with having a larger body type, often endocrine conditions.

Correlation is not causation.

Having a larger body type does not "cause" diabetes, hypertension, or any of the supposed "diseases of obesity." which are actually diseases of aging. Hypertension is not in and of itself a "disease" in any case, it is an effect caused by a systemic imbalance. Idiopathic hypertension has no traceable cause and is the most common kind of hypertension. The "diseases of obesity" affect people of all sizes.

Let us postulate that three people go to the doctor. They all stand 5'6" tall. One weighs 60 pounds, one weighs 160 pounds, and one weighs 600 pounds.

Medically speaking, it is likely that something is amiss with both the 60 pound person and the 600 pound person. However, assuming that nothing could be wrong with the 160 pound person because they fall within "normal" weight perimeters is erroneous. All three people need to be examined for potential health problems, regardless of how "healthy" they look.

The 60 pound person is likely to be treated with compassion even if zir dangerously low weight is due to self-starvation.

The 600 pound person will be treated with contempt and admonished to eat less, even if they are not overeating and their weight issues are caused by a physical dysfunction, likely an endocrine malfunction. 

Even if the 600 pound person's weight is the result of massive overeating (and I mean really massive, not being "naughty" and having a big piece of pie every day after dinner), this is the rare case and is likely caused by a condition such as Prader-Willi syndrome, or certain types of tumors affecting the satiation centers of the brain, in which the sufferer is constantly hungry.
As was pointed out by an online friend, most people are not super-obese due to conditions such as I mention here. They become super-obese due to deprivation dieting, wherein a person may temporarily lose weight but ends up regaining the weight and then some. I myself had to stop dieting so I wouldn't end up gaining more weight. Diets don't work and benefit only the diet industry.

All people deserve to be treated with compassion, regardless of their size. They should be able to express their needs and concerns to their doctor without fear of being shamed.

Many larger people forego medical treatment because they fear being shamed by medical personnel.

Many "normal" weight and slender people forego medical treatment because they have been led to believe that being a "proper size" means that they are healthy.

I worked with a woman who was very slender. She ate "right," didn't smoke, didn't drink, and had a "positive" outlook on life. She was 65 years old and should have had a long life ahead of her. She died from sudden cardiac arrest due to an undiagnosed heart condition, and everyone expressed surprise because she was thin and apparently "healthy."

Every patient deserves access to compassionate, affordable health care. No patient should be treated dismissively or with contempt because of their size.

The Cheese Hath Grated It

Lama Thubten Yeshe

Everything is Connected (The Immeasurable Heaven)

Suicide Ideation

Big trigger warning, suicide ideation mentions.

The trouble with the attitude of trying to force someone who is experiencing suicide ideation to go to the ER right away is this:

While people who are experiencing suicide ideation are more likely to actually commit suicide than people who do not experience suicide ideation, talking about FEELING suicidal is not the same thing as planning to commit suicide.

If I were going to commit suicide, I would just do it. Nobody would know about it until after the fact.

I was on a locked ward for a weekend when I was 16 because I cut my wrists. The cuts were superficial. Nobody fucking listened to a word I said about all the fuckery that was going on in my life at the time. They were quick to try and see if I was schizophrenic, asking leading questions like "have you ever hallucinated."

"Only when I'm doing drugs," I quipped, because I didn't like the self-important asshole asking the questions.

He told me I didn't need to get smart about it, and I said that someone in the room needed to get smart, and since it wasn't going to be him, it needed to be me.

He branded me a hysterical neurotic and, after that worthless diagnosis, let me leave.

I would literally kill myself before ever taking the chance of being put on a locked unit again. Even if some of them are nicer about it these days, they still don't see people as human.

While my bipolar disorder causes fuckery for me, I've learned to cope with it. However, I live in a world that wants to make me "normal" when I can never be "normal." I can never have normal sleep patterns no matter how many drugs you give me. I might fall into a tranquilized slumber and wake up in a puddle of piss, but this is not the same as having a "normal" sleep pattern, and I won't do it.

I will never have a working thyroid gland, and thyroid dysfunction also contributes to depression and weird sleep patterns.

The last time I really freaked out about shit, it wasn't my mental illness causing it, which is what everyone has been trained to assume. So, were I have gone to the hospital, they would have put me on a 36 hour psych hold. That wasn't what I needed. I needed my god damn cytomel, which the doctor hadn't yet given the pharmacy the okay to fill. Cytomel is not a psych med, it is a thyroid med. However, they would have treated me as if I were crazy and made my life an even worse pile of shit than it already is.

Lately, I have been experiencing very strong suicide ideation. I envision putting a shotgun to my chest and pulling the trigger. I don't think it's true that women avoid suicides such as gunshots to the head because we're vain. I think I'm horse-ass ugly. I wouldn't care about blowing my face away because I can't stand looking at it. However, I wouldn't want to traumatize my son by him having to see that mess. That would fuck someone up for life.

I can tell you exactly what's prompting this suicide ideation, and it isn't because I need to be on the damn psych meds that would only mess me up more.

What I need is a job that pays the bills. However, I don't do well with jobs that have a normal Monday through Friday nine to five schedule. I don't sleep well at night. I end up sleepy during the day. I fall into severe depressions working that shift.

I like working night shifts. However, I can no longer do the extremely physical work in a long term care setting or warehouse, the places where I would be able to find such shifts. Homecare work is extremely sporadic and not dependable.

Currently I'm throwing a very small newspaper route because I couldn't handle the larger one. Even with this small one, I'm in constant pain because my body never gets a day of rest. My hands and feet are swollen and my mental acuity, such as it is, is in the toilet. Everything is a never-ending blur of hell. I never have enough money.

I work all the time, delivering food and delivering papers.

I work every day of the week most weeks. I'm not lazy.

I'm the fucking square peg. I'm willing to work. I want to work. But I don't do "normal" well.

THIS is why I'm having suicide ideation. Not because I fucking need DRUGS. And no amount of having some self important twit telling me I need to "love myself" is going to remedy this fucking situation.

Nine times out of ten, people who are experiencing suicide ideation aren't planning to commit suicide.

If we're going to do it, we're not going to tell you.

The thing that everyone has been taught about forcing your unhappy friends to go to the ER is bullshit.

We need real world solutions, not pie in the sky and pharmaceuticals.

The Cheese Hath Grated It