Tuesday, June 25, 2013

The Weight Thing

Recently, the AMA ruled that obesity is a disease, and with that ruling all the old stereotypes and discussions have come out of the woodwork.  I’ll say here that I have spent the last part of my adult life overweight-at least according to medical standards.  Whether that makes me obese, I am not sure.

I am a voluptuous woman.  I have always been full figured, all of my life. It is who I am, although I did not always weigh what I weigh now. I have never, in my life been a size six or two or ten even. I’ve also always had a C sized cup if not more, not to give too much information.  When I was twenty three and joined the US Army, I ran for an hour every morning (in combat boots on cement, mind you). I ate healthy food (yes, army mess halls had good food). I was still a size sixteen on a good day, and nothing was going to change that.  The second half of my army service was done at Walter Reed Medical center. I remained a sixteen at best and still worked full time, did PT daily and had an active lifestyle. No one in my life including my supervisors ever suggesting there was anything wrong.

For me, pregnancy, while joyous, was not the glowing thing it is to some. I had various issues with both pregnancies, and both times gained weight-which never seemed to go off no matter what I did. I was still healthy and active. After the birth of my thirty year old, I ran an in home day care center where I cared for up to ten children from six am to five pm.  We ran, we played, and I worked, got down on the floor. As a result my household had to have all of its meals approved by the USDA during the week .We ate extremely healthily with two servings of fruits and vegetables at lunch and dinner and so on and so forth.  On the weekend I hiked, coaches sports, helped my husband at work. My second pregnancy required something close to bed rest, and my boredom was sated by eating and watching day time television (why I now never watch daytime TV, even in a news crisis). 

  After my C section and recovery I was back up again, active as usual, chasing after an active toddler and being the after school home to a group of ten year olds. As life progressed, it remained more active. Golf, hiking, day to day business kept me active mentally and physically. While some of the weight dropped off immediately after returning to my normal life style, much did not.  I found this very frustrating at first, especially as my husband was six feet, 130 at his heaviest, never worked out and ate (literally) everything he wanted including a chocolate milkshake before bed all of his adult life.  His position required us to go to different private and city clubs each m month where the chef on call would try to out cook the previous chef.  Invariably I would only be able to eat a third, and my husband would finish what I could not. He wore a size thirty pant at his heaviest.  Thankfully, he knew that he was blessed by genetics and metabolism. I eventually decided I would remain who I was, and be happy with that person. I remained that way for many years, during which time I climbed church bell towers, climbed European mountains and ate the food of every country-all while being overweight. I did not however, gain weight. Ever.  My weight post pregnancy recovery was constant for twenty years.  The only times I have ever gained weight were short periods. I simply was unable to lose weight-no matter what I did.


When my husband died, I went through a deep period of depression. For six months I ate all day and spent money all day. At the end of that time, I fortunately “snapped out of it” and slowly returned to my normal life style.  Since I was still depressed, I decided to join a diet program. For the fee of three thousand dollars a year, plus two hundred dollars a month, I could eat prepackaged food-and still have to purchase dairy products and fruits and vegetables on a weekly basis. I existed on between twelve hundred and fifteen hundred calories, exercised daily…………and lost 70 pounds over more than three years!  During my diet I ate nothing approaching normal food, and since I still lived with others, got to watch them eat regular food during that time.  At the end of that period, I screamed a huge NO, many times over. 


That life was not for me. I now continue to eat primarily healthy foods-including both vegetables and salads at meals, nuts , olive oil, a small glass of red wine daily, and desserts-almost daily. I exercise regularly by walking or doing water aerobics ( where I can maintain high intensity for a full hour). .  Last week I climbed up the mountain sized hill at the renaissance fair.While I had to ice my knee the next day, my heart was just fine, as was the rest of my physical being.  My blood pressure is 120 over eighty. When I travel, I walk back roads, cobblestones, I do everything that others do with the exception of climbing stairs (thanks to a my knee injury it is forbidden). My days are filled with sewing, quilting, working in the garden. Soon they will be filled with minor home improvements as we move and replant and paint and the like. The only times I have been hospitalized were for childbirth and a D and C until my stress (not heart) attack at sixty  Overweight?  Absolutely.  Sick?  I don't happen to think so.

On one level I understand the logic, I truly do. The AMA wishes to make certain procedures more affordable under insurance. In theory I think this is a good idea. The thing is thought, that the other primary purpose of making other designated conditions diseases was to reduce the stigma. I don't see this happening here, if only because being overweight is simply so visible.  Unfortunately, I see this diagnosis as an opportunity to line the pockets of folks in the diet surgery and diet industry -both of which are poorly regulated by the AMA or anyone else, for that matter.  And frankly there are way to many doctors out there who blame every single illness an overweight person might have on that weight-ignoring other factors. I have a damaged knee-not from my weight, however, but from running on cement in combat boots for ten years and falling down the stairs.  Too often already a doctor simply says "lose weight" or "eat less" no matter the complaint.

Is weight related to health? In many cases it is, and I do not mean to downplay that in any way!  It is however, just one aspect, and to assume that the non heavy are necessarily healthier would be a mistake. Is the skinny guy who runs on the sidewalk and has to have multiple knee surgeries healthier. The guy who smokes?  The guy in the suit who stops on the way home for two drinks every night or walks in the door and has a cocktail? The skinny guy who never exercises and simply relies on his skinniness for health? 

Or is it, again,  just that overweight people are more visible?  Recently, at an online place I visit,  a contributor posted a picture of Kim Kardashian-fully pregnant and probably overweight according to medical standards as well, but looking happy and healthy.  She was eating an ice cream cone. The person noted: " I'mnot sure in her condition I would be seen eating the ice cream".  Really?  Are we not allowed to behave and eat normally just because we are overweight? Will we visually micro manage what everyone is eating and correlate that to their weight?  I eat ice cream cones. I also eat salads twice a day, drink low fat milk, have fruit for snacks and prefer fish for my protein.

So be it.

16 comments:

  1. I am overweight also. I had a talk with my doc yesterday about risk factors for heart problems, since I'm applying for Medicare and interested in what level of supplemental insurance to buy.

    He pulled up a risk calculator and entered my age, cholesterol, bp, nondiabetic, nonsmoker, no family history. I am low risk. I asked about my weight as a factor. He said it wasn't requested on the calculator.

    I, too, eat fairly well and exercise. I've been about 40 pounds overweight for a couple of decades.

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    1. Linda, my weight differential is more, but I have decided to concentrating on eating good foods especially looking at the carb area and i do healthy things, rather than concentrate on the weight at this point.

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  2. Barb, I do concur with most of what you've posted. I was on a bike ride a couple of weeks ago with a woman who had recently lost 75 pounds, and had another 50 or so to go (according to her, not me!) and she kicked my butt speed wise. She proudly shared her improved vitals with me, all now close to normal as compared to before. Weight absolutely does not automatically correlate with good or bad health.

    My issue on the other blog had to do with those claims that weight reduction cannot be accomplished via lifestyle change alone. Of course it can, but I absolutely understand if someone feels the trade off is to high.

    It might surprise you to know that even after running off approximately 500 calories a day, I still have to keep my daily food intake to no more than 1600 calories or risk gaining weight. If I stopped running, my daily allotment would drop to approximately 1100 calories a day, pretty austere, but a reality of my age (50) and slowing metabolism.

    I appreciate being able to have had a civil exchange on a sensitive but important topic.

    (BTW - runners have long been shown to have healthier knees than the generally non running public. The number one and two causes of knee pain are age, and excess weight. Sometimes pre-existing conditions rear their heads, which then impact the knees, but rarely is it the act of running itself. A quick Google search will bring up scads of articles on this issue, including one notable, decades long study, of runners and their knees by the New York Times.)

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    1. Well, I'll say here that I do do not believe that weight can necessarily be lost through lifestyle change alone-in fact my physician agrees strongly with me-there are too many other factors involved.

      Lifestyle changes increase health, they do not automatically or necessarily decrease weight. I drastically increased exercise while not adjusting what I ate and in fact, did not lose a pound. I am much healthier, at the same weight.

      There is a frightening amount of lack of knowledge and pre concieved notions about weigh, as well as cures. Only about fifty percent of lap band surgeries are successful in the long run (half had to have them removed or have a secondary abdominal surgery). Diet pills are addictive and the prepackaged diet products be they food or supplements, almost all have side effects.

      In my case I eat well over 1600 calories and have not gained weight........my weight remains stable. So I guess I'll stay right where I am at the 2000 calorie and basic exercise range. However, I have finished menopause in the full so probably in a slightly better place....

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    2. I'm a bit baffled by your reply. If weight loss is not accomplished through lifestyle changes (i.e., less calories in, more calories out) than how do you and your doctor believe it is accomplished?

      I ask because I've been managing my weight for over 30 years by applying these pretty basic principals. (Weight, not health. I understand health is more complicated than a simple number on a scale.)

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    3. If I am not being clear, my fault. I'm suggesting that some people simply will not lose weight no matter diet or exercise-and that's just fine in many cases, including mine. Sometimes acceptance with the current standard is just fine. I'm also suggesting that generalizations about anything, including obesity are unwise. My fault,for the confusion. typing on a tablet.

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    4. My question is: if health is good to excellent and weight is high, what is the problem?
      Seems heavy people get judged all the time. Sad.

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  3. Hey Barb, I think you might be right -- but I hope you're wrong -- when you say this diagnosis might prove an opportunity for folks in the diet surgery and diet industry to line their pockets. And you might be wrong -- but I hope you're right -- about Kim Kardashian. Because I happen to have a bowl of ice cream in front of me right now!

    Btw, you might be interested in the NPR program from this morning on the issue -- at http://www.npr.org/templates/story/story.php?storyId=195194243

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  4. Interesting -I scanned but willhave to go back and read in detail. There are no easy answers to this one and it is surely a problem that I see, especially in kids. That said, a week without ice cream...........I dont want to think about it!

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  5. I'm curious what blog you and Tamara are discussing and would like to read it for myself.

    Personally, I know over a dozen people who've had knee replacements, myself included, and most carry extra weight. The success of our recoveries was due more to activity level than weight. I hadn't paid attention until reading this post that none of the runners I know have had knee replacements. Problems yes, but not replacements.

    For myself, proper nutrition alone, or increased exercise alone, has not brought weight loss. Finding the correct balance is an ongoing issue!

    Thanks for a thoughtful post, and the replies!
    Rose

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  6. i'm really surprised that you were able to get away with being overweight in the army especially in a medical setting. in 1979-1980 i was in the army and was put on a weight program with weekly weigh-ins even though i was only 3 pounds over the bmi for a 5'7" female at 20 years of age.

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    1. The rules may have changed. I was not considered overweight wearing a size 16 nurses uniform. I passed every single pt test with flying colors. Perhaps perceptions of weight have changed for the worse? Or perhaps medical folks were more realistic about weight and health.

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  7. I am also a healthy woman with 40 pound more than in my 20s. Some thyroid issues are under control but might prevent weight loss. Be it so.
    I appreciate your post on weight. By chance I am just reading a book that comes to similar conclusions.
    Medical and insurance standards of a "healthy weight" has changed over time - and not because of supporting facts.

    As long as we are fit and energetic enough to lead an active life we should not allow anybody to criticize us for weight.

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  8. Just wanted to add: People come in different kinds and sizes...

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