Wednesday, April 14, 2010

I'm back and I'm mad

Thank you all for your kind words and comments. I really, really appreciate them, and I intend to answer them all, I'm just very slow. Thank you.

Okay, so you know: rant ahead. You might want to just skip this. I just really need to get it out, and a private text file is not enough this time.

Now. You know what annoys me? Lately it's articles like this that piss me right off.

http://www.nytimes.com/2010/04/14/health/14diabetes.html

Seems pretty straightforward; health insurance company teaming up with YMCA to offer a program for weight loss/health/diabetes prevention.

It includes at least one success story from someone who'd been on the YMCA program, talking about how wonderful it was, how well it worked, it wasn't like those other weight loss things where she'd gained it all back.

Now, why would I get so stabby about such a wonderful feel good story like that where people learn to get healthy and help themselves and it reduces all our bills blah blah blah?

1. 49 pounds. She says she lost 49 pounds. Why isn't there a huge blinking banner that says RESULTS NOT TYPICAL?

Let's put all the cards on the table. I am 5'8". I weigh 205 pounds. I am obese. I am not even in the pretty "overweight" category.

10 years ago I was still 5'8" and weighed, oh, about 190-195 pounds. After 12+ years of body guilt about "if only I'd get off the couch and start exercising I could be thin like everyone says I could be", I really went and did it, tried to get skinny. (I was not an overweight child, although I was always at the top of height/weight charts for my age. I hit puberty and got breasts, hips, pubic hair, and 50 pounds. SURPRISE! You lose the teenage genetic lotto!)

I started eating low fat, and almost no sugar. I kept a food diary. I didn't limit calories, but I did watch carefully what I ate and how much. That was good for about 2 months and 10 pounds, and then it stopped, and it didn't budge. Did I mention this spanned both Thanksgiving and Christmas?

Then I joined a gym and hired a personal trainer. At this point my new part-time job started, called "exercise". I did 1 hour of cardio every day of the week (until the trainer told me to take a day off once a week). I was weight-lifting 3 days a week, full-circuit, legs to shoulders to triceps and all that. In addition there were the stretches, the abdominal exercises (daily). Oh yeah, and a once a week yoga class. And, you know, showering and changing. You add up the hours. Yes, I was also employed full-time.

This continued for about 6 months until I ripped the meniscus in one of my knees (also getting the first of the back injuries along the way). I avoided surgery (see, fatty saved you some money) but I went through several months of physical therapy. That was fun, that added 1.5 hours of stretches and exercises EVERY DAY in addition to therapy sessions in addition to trying to get back to the 6-days-a-week cardio, 3-days-a-week lifting.

Over the 6 months I lost about 15 pounds. Yes, that's it. That's all. 1/2 pound in a week was a GOOD week. I dropped from a size 18 to a 12.

There is this myth that all fat people need to do is just start moving, man, get up and take a walk, stop gorging on hamburgers and soda and pizza. I'm going to do a little self-righteous ranting: do you KNOW the last time I had a soda? No, not even diet. I WALK or BIKE to work. How many of my thin (e.g. 'healthy' since they aren't fat) coworkers do that? How many of them go to the gym on a regular basis? How many eat fast food garbage every day? While I'm sure that there's a pool of people that would drop 50 pounds if they started to eat healthier food and exercise regularly (see story above), THIS IS NOT UNIVERSALLY TRUE.

I am all for encouraging people to exercise and eat healthy food. But what happens when they don't magically turn thin?

So don't talk to me about self-control. I know what self-control is and I damn well have it.

2. This program "will be available at no cost to participants". And just a couple paragraphs later I see "investing tens of millions of dollars in this initiative". Soooo.. this won't cost any more money. All those tens of millions are coming out of the amazing cost savings once all those obese people get thin and don't get diabetes. And hey, if it's a successful program and actually encourages healthy behavior and not starving yourself or food guilt, then maybe it will. That'd be great, and I do hope that happens.

3. this quote:
"...expand on the success of a clinically proved program that has been offered by the Y. Based on evidence drawn from that program, people who are pre-diabetic and lose just 5 percent of their body weight can reduce their chances of developing the disease by almost 60 percent"

Someone want to show me this clinically proved program? Some numbers? Some even mention of this study at all except in passing? Because we all know that all clinical studies are COMPLETELY TRUE and never have false data or doctored results or might be run by someone who has a vested interest in certain results or anything.

Next up. 5% of my body weight is 10 pounds. This is easily in my 185-205 "normal" weight range (I'm at the top right now, and not surprisingly so, as I haven't been exercising much. There's been some more back problems and I really don't feel like screwing it up again (seeing a chiro now. It's interesting. So far she's been able to give me some exercises and stretches (oh, those stretches. I will never be free of them) that are loosening things up enough that I can sort of bend over now at the end of the day, which let me tell you is a big win. Yoga and massage help too, but not so much as this) Normal is what's normal for me. I can go up and down in here without too much difficulty. Going higher or lower requires extraordinary effort (see above)

So let's take the study at face value. Cool, eating healthy and exercising (which we're going to assume that these people were not doing) reduces risk of developing type 2 diabetes. Yay! Note that there is no reference to the study and also no reference to "more is better". Yet that is the IMPLICIT SUGGESTION in this article. If all those fatties could drop 33% of their weight, NO ONE would get diabetes!

Another story: I got the family history. Dad has it, uncle has, great uncle has it. Yeah, genetics sucks. Also from the family line: my weight, my hair, my height. Nobody says the height is unhealthy (the jury's still out on the hair, I guess), but they seem to think I have some control over the genetics of weight. Anyway, I digress.

Uncle, being an MD and knowing he was at risk for the big D, is trim. Exercised all the time. Ate all healthy and chicken breasts and stuff. Aunt kept him at it when he started flagging. The end of the story: he still got diabetes anyway.

Note: 10 pounds is not even close to 49 pounds.

3. Back to our little anecdote:
"In reading about diabetes, she realized she was at risk for developing the Type 2 version.

And yet, she said, 'my doctors had never said one word about it.' "

In what wooowoo universe does SHE live in? Do you KNOW how much I have avoided and dreaded doctors just to get around the "weight talk"? And if you don't know what I'm talking about, be very glad. And, family history of diabetes is about the FIRST THING I EVER GET ASKED walking into any doctor, even if it's the damn dermatologist.

4. Ms. Schenetzke, who lost 49 pounds, has stuck with her healthy habits. Excellent! She says:
"Unlike other programs, where she quickly regained whatever weight she had lost, this represented a permanent change, she said. 'I thought from the beginning that it would work.'"

You have been on this plan since NOVEMBER darling, that would be... 6 months. 95% of all weight loss outside of the "normal range" disappears within 5 years. 1st year is usually pretty good. How can we know this is a permanent change? arggggh

5. But I really like this:
"'Unlike conventional gyms, the Y has and always has had a message of health'"
Yay, for once, someone uses the term "healthy", and not "thin".

6. and last:

"And unlike some of the federally mandated experiments called for in the new health care law, Ms. Darling said, the results will be quickly apparent. 'We don’t have to wait five years.'"

Why not? what are you going to find out in 6 months?
60% of your people don't get diabetes in the first year? And the 2nd, 3rd, 4th, 5th years don't matter? Does it matter if people stick to your lifestyle exercise plan? How can you tell they will? WTF, this makes no sense at all.

And lest you think I'm just ranting for fun, read this. I now get the privilege of paying up to 50% more for my health insurance costs. Because I'm fat, nevermind anything else. Did you not think that perhaps this is ONE MORE WAY FOR THESE INSURANCE COMPANIES TO MAKE MONEY?

http://www.nytimes.com/2010/04/13/health/13land.html

They don't even hide it.

"Premium discounts for people who achieve health objectives — or who are thin, have normal blood pressure or do not smoke to begin with..."

It's not about healthy, it's about THIN.

I do not look fondly upon the people who put my 2-year-old niece on a diet because she "looked fat". Even my brother did a double take when they told her to get more exercise, seeing as she does very little but RUN AROUND ALL DAY (in our short scientific study, 100% of people who observe her on a daily basis agree with that statement!)

Did it ever possibly occur to them that perhaps the same genetics that predispose me to heavier weight might also dispose me to type 2 diabetes? That the relation is correlational, not causational? Oh no, I just need to back away from the pizza and donuts. SCREW YOU self-righteous donut eaters. It's not me eating them on Friday mornings.

5 comments:

Hippy Goodwife said...

wow. I don't think I have ever seen you write something so angry. I have been more or less the weight I am now for all of my adult life. I was about 30 lbs lighter right after I gave birth. A not very healthy combination of long term "morning" sickness, crippling depression and hormonal problems. I was in no way healthier than I am now. Just thinner. Fat people are the new enemy. But you knew that.
Hang in there with the chiro. I here is helps.

Pandora's Box of FIber said...

Amen sister! I'm in the same boat you are...except I am an insulin dependent diabetic. and those twats wanna say that it was preventable? I think not!

No matter what I do, my weight doesn't budge. So I'd like to see a real solution. Not the flowery commentating of insolent, uneducated, thin people.

fillyjonk said...

I LOVE YOU.

Seriously, if I could get rid of all the "body guilt" I carry around because I weigh more than I am "supposed" to (even though i exercise and try to eat healthfully), I'd feel like I had lost 40 pounds.

I really am scared that fat people will be the new enemy - that I will be pushed by my health insurance until I develop some kind of disorder - because I "need to lose weight." Or that I will start starving myself because I am told to, and I will either pass out in front of class or will be very grumpy and very angry (like I was back in college when I tried going on a 1200 calorie a day diet)

I don't know. I work out an hour a day most days. I wish doctors would hear that and just leave me the frack alone. Yes, I know I'm at risk for eleventy million things. Yes, I'm trying to be healthy. But I get so sick of being told what I do is NEVER enough.

Cookie said...

I love you.

I resent my health care dollars being wasted on old guys and their little blue pills. But that's a rant for another day and a different blog. ;^)

xo

Kristen said...

I'm so with you on this one. I had gastric bypass surgery and now I'm 5'8" and 220. This is what I weighed in high school. This is what I weighed my junior year of high school when I lived in southern Germany and walked up and down a mountain all the time.

My age is catching up, though. My blood pressure is starting to creep up there. I hope we have a lovely summer so I can ride my bike around again.