Fat Chicks Rule

Finding blame and paying more

At one of my physicals, the nurse taking my vitals wanted to weigh me. I don't get weighed at the doctor's office and told her so.  (If the doctor really wants to know my weight, I'll be willing to be weighed by him in private as long as the number doesn't go into the chart. That hasn't happened.) She said that some insurance companies want the number. I told her that that was one of the reasons I didn't want to get weighed.

I get my insurance through my job and at the moment there are no extra charges for perceived health issues. There are discounts to diet programs and gyms. I worry constantly that this will change. Other places already are looking to hit people while they're down.

For the past few years, companies have experimented with tying health insurance premiums to people's health. Here's how it works: Employees go through medical and biometric testing as part of their health insurance open-enrollment process. They are weighed, their height and blood pressure are measured, and their blood is drawn. Those with high scores on cholesterol, glucose and blood pressure -- or with chronic conditions like diabetes -- are told they will have to pay higher premiums unless they actively try to address any risky conditions.

One of the reasons I am very pro-universal health care is that when we have for-profit system of health care, people who tend to be genetically prone to certain diseases will be charged more or denied coverage. It's a slippery slope that this will condemn all fat people regardless of their health.

Meanwhile UCLA Professor Abigal Saguy points out in her op-ed about fat prejudice.

Despite the fact that body weight is largely determined by an individual’s biology, genetics and social environment, medical providers often blame patients for their weight and blame their weight for any health problems they have. 

Health insurance isn't like car insurance. Driving a car isn't a right: you need to demonstrate your competency through your actions. Health insurance means that you don't go broke for an illness, acute or chronic. I don't get the logic of telling people they need to get healthy before being allowed access to health care. 

The good news (for the US) is that in 2014 you cannot be denied health insurance based on health status. It also means there are affordable health care options. This is good news for fat people who often are either denied health insurance or given outrageously high priced options.

Health insurance companies offering coverage to individuals and small employers will only be allowed to vary premiums based on age, tobacco use, family size, and geography.  Basing premiums on other factors will be illegal.

 

Not a Glutton

The fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM) Version 5 will be out in the Spring of 2013.  In it Binge Eating Disorder (BED) will be added for the first time, defined as this: 

• Criteria include frequent overeating—at least once a week for three months— combined with lack of control, marked feelings of distress, and are associated with three or more of the following:
• eating much more rapidly than normal
• eating until feeling uncomfortably full
• eating large amounts of food when not feeling physically hungry
• eating alone because of feeling embarrassed by how much one is eating.

Dr. Allen Frances of Psychology Today lists the 10 worst issues in DSM 5 and one of those issues includes BED: 

Excessive eating 12 times in 3 months is no longer just a manifestation of gluttony and the easy availability of really great tasting food. DSM 5 has instead turned it into a psychiatric illness called Binge Eating Disorder.

For an MD, Dr. Frances appears to know very little about eating disorders and more about giving moral judgements upon overeaters, essentially calling them gluttons. 

BED isn't overeating at a fine restaurant or at a great meal, it's compulsive overeating past the point of fullness, without taste or enjoyment. It's similar to bulimia but without vomiting. 

Now as far as BED being listed in the DSM, I have mixed feelings. On one hand, having suffered from BED, it's nice to see it acknowledge as something real instead of "Stop eating so much, fattie." However I am wary that its being added opens up a psychological issue to diet drugs. Something I have repeatedly mentioned never work.  And I worry because the American Psychiatric Association which is not known to be fat positive is adding not adding BED because how it affects the self esteem and well being of the person, but because the worst case scenario is they might become fat. 

Fat, Love, and Self esteem

Until I began dating my husband Jon, I was certain I was going to I was going to die an old maid. I had piss poor very brief relationships either with idiots or assholes.

I meet Jon in college. We were both members of the English Club. Jon was a computer/sci-fi geek and I wrote poetry about death. (Seriously, I was known as Miss Death and people would yell out death, death when I got on the stage at monthly poetry readings.) In the beginning Jon and I were friends. I was painfully shy and certain that no man would want a relationship with a fat girl. (There were in fact 2 or 3 men in college that liked me but didn't want a relationship), but I was hung up on getting into a relationship like my other friends hopefully with someone good looking.

I think that I set off two vibes, one I was ashamed of my body, and two, I didn't think a fat girl deserved anything. I was absolutely sure from the ages of 14 to 23, if I lost weight I would find a guy.

After college Jon went to Japan for two years and I went to Graduate School. I had no boyfriends in this time, except someone I sort of fooled around with and someone who met me, talked to me, seemed to like me, then for some reason backed off.

During every fling, date, or episode of "just friends making out" I dieted, and was ashamed of my body. It never occurred to me that it wasn't the fat that turned people off but the low self-esteem and belief I could diet my way to a good relationship.

Jon and I really didn't stay in touch during those two years but we shared a best friend. She was having a baby and wanted us to be the godparents. When Jon came back from Japan, I happed to be in a period of not dieting. It was after I realized Weight Watchers was never going to work and I haven't yet been introduced to low carb. I was still convinced thin was in, but that belief was beginning to wane. I started to think maybe I wasn't meant to be thin. In fact I began to learn to love my body and accept it.

It's no surprise that soon after Jon came home, we hooked up. Jon was funny, good looking, had an easy going nature, and could tolerate both my shyness especially around my body and my quirky sense of humor. 

We dated causal at first, then it got more serious. We eventually married in 2000. Jon was not only my husband but my first long term relationship. He doesn't like it when I say it, but my relationship with him is the one part of my life that came out as I wanted. I've always been glad that he tolerated my low self-esteem. He is one of the few people I have no problem parading around naked in front of. Jon loves my boobs and he loves to squeeze me. He likes big women and he never hates a person for how they look.

I'm in the process of reading Fat Sex  by Rebecca Jane Weinstein. The book isn't about Fat Sex per se, but instead fat people talking about sex. (I'd suggest Big Big Love by Hanne Blank as a good guide to actual fat sex.)

In the book there is a chapter about an FA who is often ribbed about his love for big women. I laughed because none of Jon's friends have ever ribbed him for me and he never ever thinks of me as an embarrassment. I'm sure the beautiful people laugh at us but neither of us care. 

The object of this post isn't that fat women can snag a man. Yes, they can. There are plenty of men who like big women or prefer personality over looks. The point here was it was the low self-esteem that turned off men. That in order to be loved, you have to learn to love yourself first. 

 

New England Journal of Medicine - Don't help.

Recently the New England Journal of Medicine came out with a "Study" showing seven myths and six assumptions about "obesity" Although not a single one is a myth or presumption about fatness, say how the obesity epidemic is overblown, how being fat doesn't affect your mortality except for the supersized, or how everyone ignores the rise of dieting came with the rise in fatness. Instead every single one is about weight loss/ dieting. Some of it is fairly harmless like sex only burns about 14 calories compared to 300, or that breast feeding doesn't make your kids thin. Please don't stop having sex or breastfeeding because of this study as both have health benefits. Others aren't as helpful, that gym classes don't make you thin. That's right they don't, regular exercise for most people despite their size makes them healthy, not neccessarily thin. 

Normally I would say this is a positive article because it shows that healthy habits don't actually mean weight loss. 

Until I got to one of the myths.

Within weight-loss trials, more rapid and greater initial weight loss has been associated with lower body weight at the end of long-term follow-up

Essentially the "Myth busted" is that rapid weight loss works better than steady weight loss. The authors point out that some people have been successful at it. Depends how you define success. In 1999-2000, I was a success. I lost 35-40 pounds (I was still fat) in about 6 months and while I never got to a goal weight, I kept the weight loss for another year. But a year after that I was back to my original weight. A number that I've hovered within 10 pounds of for the last 10 years. I never said people can't lose weight, I said they can't keep it off in the long run. Whether they lose it slowly or quickly. 

Rapid weight loss can lead to gallstones, and loss of vitamins and minerals.  Most rapid weight loss comes from very low calorie diets either liquid diets or weight loss surgery which means you aren't eating enough for your body to function properly. 

I think Marion Nestle hits the nail on the head on the reason for this "study".

"I think it’s weird.  I don’t get it," said Marion Nestle of New York University. "I can’t understand the point of the paper unless it’s to say that the only things that work are drugs, bariatric surgery, and meal replacements, all of which are made by companies with financial ties to the authors. " She noted that the researchers who signed the paper also provided a long list of companies they have been paid to work with. 

If you read the affliations, you get big food, big pharma, and the diet industry. As mentioned last week, the diet industry is expected to make 66 billion in 2013.

Not surprising that they want you to not eat healthy food and exercise (To be honest they don't actually say that) and instead to take drugs, get surgery, and go on crash diets.