Tuesday, June 17, 2008

What Do the Obese Think?

A recent survey found that being obese invites social discrimination, but the obese do not wish to be labeled as "sick" or diseased. As noted in the press release about the survey findings:

"Obese people frequently feel overwhelmed and disheartened by the publicity about their condition," he said. "They often feel disrespected and not understood by medical practitioners. Our participants express the view very forcefully that they feel victimized by current social attitudes about obesity. To be told that, in addition to the problems that they recognize only too well, they are now regarded as 'sick' is unlikely to assist them to find a solution."

Study participants said they find it difficult to act on the health messages about obesity, he said. Most participants reported that they had tried weight loss remedies that their physician recommended and were generally dissatisfied with the help doctors provide.

Health care providers' efforts to convince overweight patients to lose weight are largely unsuccessful, Komesaroff believes, possibly because they do not understand the key issues that obese people face.


  1. I didn't get obese until some 20 years ago, when I was in my mid-40's. Since I'd already launched my kids, established my career, and developed my relationship with my spouse, I'd say the key issues I faced were two:
    (1) not knowing that low-carb could have prevented much of the weight gain in the first place
    (2) miscellaneous health problems such as aching joints

    Thank goodness for Gary Taubes' book convincing me that low carb is more than safe. Just 5 more pounds to lose and I'll be officially only overweight instead of obese!

    My guess is that for the majority of overweight people, lack of knowledge is also the key issue. Understanding can be over-rated. (Although every once in a while I think it would be nice if my doctor would tell me that she understands why I'm a bit angry.)

  2. Anonymous5:51 PM

    oh brother.

    "Health care providers' efforts to convince overweight patients to lose weight are largely unsuccessful"

    could it be because they have no track record of successful programs? The only ones who do are the bestselling diet authors, who at least prove that their programs work well enough for enough people to get some word of mouth endorsement.

  3. Anonymous9:57 PM

    What is obese? what is overweight? what is fat? what is thin & what is 'too' thin? I find drawing a line somewhere and saying anyone on this side is normal & anyone on that side is not normal is pretty silly, especially when we are all supposed to be 'individuals'.
    It is a bit like everything in moderation what is moderate to one person may not be moderate to another & simlarly what is normal to another may not be normal for someone else but it may be normal for them? Or taking a whole lot of measurements & saying anything over this one here is bad! or better still changing what was once normal & making it abnormal thereby creating a whole new class of sick people! Herein lies the danger for us all when "experts" suddenly are advising law makers on what is considered normal in so far as body measurements or food intake goes. We all know how wonderfully spot on all the 'experts' are in regards to nutrition. & now we have those lovely people in the EU starting to make decisions that will ultimately effect us all (codex) in regards to what vitamins & minerals we can all take & in what amounts we will be able to take them. But rest assured they will be normal, minimum, maximum or moderate and as far as the busy-body brigade are concerned healthy!!!!!!

  4. "Study participants said they find it difficult to act on the health messages about obesity, he said. Most participants reported that they had tried weight loss remedies that their physician recommended and were generally dissatisfied with the help doctors provide."

    Yeah, I'll say. The problem I've had with most doctors so far is that they simply refuse to believe that a fat person is telling the truth about what they eat. I have followed the diet advice given to me by doctors to the letter and continued to gain weight. Their disbelief when I tell thim this has been incredibly discouraging.

    I've suspected that I have PCOS for years, and I've described my textbook symptoms to so many doctors now that I've lost count. In every case, they have told me that the symptoms will go away once I lose weight, ignoring the fact that my main complaint has been an inability to lose no matter what diet and exercise plan I follow. Finally, I was properly diagnosed last year, but at my most recent check-up the doctor asked me if I'd thought about making better food choices.

    Uh, better than what? Your prescribed low-GI diet that I have been following for the last few years? The low-fat vegan diet? Weight watchers?

    Maybe if more doctors actually listened to their fat patients' experiences with these kinds of diets, they would realize that they don't work for everyone. Perhaps then they would stop spouting the same tired advice and dismissing their patients' problems under the rubric of "non-compliance".

  5. "Health care providers' efforts to convince overweight patients to lose weight are largely unsuccessful, Komesaroff believes, possibly because they do not understand the key issues that obese people face."

    Yes. Metabolism and nutrition are the key issues, and they don't understand them.

  6. I think it is absolutely imperative that obesity be considered a disease.

    There are numerous treatments during and after weight loss that should be covered by insurance - but aren't.

    If I want to have the drapes of skin removed from my arms, I probably need to pay that out of pocket (when, in reality, it is a complication of my medical condition, obesity). I already paid for a lot of skin to be removed from my abdomen ... that was 12k. All paid myself.

    I also have leptin deficiency after weight loss. In spite of generous cal intake, good nutrition, a healthy 21% bodyfat, and stable weight, my body makes the leptin of a starving anoretic because my fat cells are too small relative to what my insulin-damaged body expects. This causes serious complications like infertility and osteoporosis. Right now I am participating in a study and getting my leptin for free... but what happens when the study ends? If obesity isn't a disease, I don't need this medicine, therefore they ain't paying. That's wrong. People who are at a healthy bodyfat after weight loss need leptin like type 2 diabetics need insulin to normalize blood sugar. Technically they can live without it (most type 2s can anyway) but they can't live nearly as healthfully.

    Only good things can come from considering obesity a disease.

    It is a disease.

    The sooner we do away with BS myths that anyone who loses sight of their food can become hugely overweight, that it is a matter of morals, the better off all of us will be.

    Fat people who resist the label: do you think denying the truth makes thin people think better of us? Does it make you think better of yourself? If obesity isn't a disease, it stands to reason all obese people are personality defects. The only alternative is that obesity is a neutral physical trait which is blatantly untrue - morbid obesity is entirely unhealthy even when considered independently of its association with the metabolic syndrome, for numerous reasons I won't get into here. It defies intuition of to believe real obesity as a neutral trait a condition that so impairs something as basic as mobility. IMO, it is wishful thinking bordering on a self delusion of obese people.
    Considering the neutrality of obesity is a non-argument (that is to say, being afflicted with obesity is an objective negative), therefore it must be true all of us are either (a) suffering from some kind of illness or body malfunction (b) deviants, immoral defects, gluttons and sloths the lot.

    I just can't for the life of me understand why it is even an argument. It is so obviously a disease.

  7. mander - I had pretty much the exact same experience. At 16 I went to one endo for my "weird hormone problems" and lack of periods.

    She told me to lose weight.
    Now at 16 I had no idea what a carbohydrate was, much less PCOS and the cause. I just inuitively knew I had a hormone imbalance with too much male hormones (because of all the acne and facial hair) and I also knew that my weight was a PART of the problem, not a cause.

    She was a very nice lady, she just didn't get it.

    She wanted to put me on birth control. It was then I knew she REALLY didn't get it. I didn't want a period just to have a period - I viewed my lack of a period as something being really wrong.

    I never went to another doctor about it, figuring it was hopeless. Being told to "lose weight" made as much sense to me as telling someone with cancer "just lose your cancer cells and you'll live". Uh, ya think? Too bad the weight is something that happened and I have no control over it as far as I know? I was eating when hungry. What did they think I was binging, shoving food in my mouth and purposely becoming fat?

    Discovered the atkins diet when I was 20.
    Symptoms of PCOS disappeared in a weekend (requiring no real weight loss at all). Terrible acne I had since 9 yrs old - gone in a weekends time. Next month I had a period and every month thereafter (until I lost so much weight that my body began thinking it was starving, but that's another issue).

    Could hardly believe the truth when I learned about it. Felt really angry. Went through stages of it till I reached acceptance.

    After low carbing for over 5 years, nothing surprises me anymore. Doctors are like laypeople with a little bit of education about how to prescribe meds. They don't know much about health.

  8. Anonymous4:24 PM

    Are you absolutely sure that anyone really wants to know what "the obese think"?

    To obese people, doctors are just evil, conniving business people - with a lot of education about how to sell meds! And since there is no real cure, they only sell BS.

    After a life of rejection, grief, anguish, bitter loneliness, and isolation (beyond anything most people would want to imagine bothering to endure) I have come to hate not only doctors (the last one spit in my face, yelling at me for not responding to his useless advise) but I have very slowly, but surely, come to hate everything about my own species.

    I was born a happy child. But that would soon change when my parents saw that I would never be "normal", i.e. of value to them, like other people's children. I was soon subjected to every low-fat, no-fat, low-carb, no-carb, and every other worthless "sensible diet" known to medicine since the 1970s. My weight only stair-stepped ever upward. In the end neither parent could bear to look at "the blob", or each other("It was your genetics!!! You didn't tell me about that FAT grandparent before we decided to have children!!!" - "No!!! It was your bad eating habits, in front of "your" stupid blob of a kid!!!" etc, etc, etc, ... ). They split up. I never wanted to see either of them again after I was in my early twenty's. Neither of them had any desire to be reminded of "the blob", either.

    I keep to my self, these days, literately an ugly, broken, scarred hulk. At night I wander the mountains in the isolated wilderness (Idiotic Cliche' #1 - exercise helps), where I moved to voluntarily remove myself from the "normals"; crying - sometimes raging - to myself at the worthless, pointless sham life is. If ever their was a caricature of a tortured denizen crawled up out of hell, I would be it.

    I will not continue. My pain could fill volumes, and would still only fall on deaf ears.

    YES! It is a disease! But a disease for which the stricken have not been so punished, for having a disease, since Medieval times!

    Is the hypocrisy that I have been subjected to from this "human" species, only vented by them as a substitute? One to make up for a deficient of instinctual racism, an intolerance they are not allowed to express by society's decree? This is the only explanation for their "sanctioned" cruelty I can surmise.

    So, if ever you are in the Rocky Mt's after dark, and hear something that does not sound completely human, anymore - it is not. I turned my back on that, now, and am looking forward to a more merciful state, of future nonexistence. After being forced to abandon all positive aspirations, I at least have something to look forward to.