Weight, health, food, and bodies [TW]

And assorted issues pertaining thereto. I'mma give a blanket content warning for discussion of:

• Weight (also weight gain, weight loss)
• Medical treatment/professionalism, weight-related & not
• Eating disorders & disordered eating
• Sex and gender (no doubt)

This is a thread to discuss weight/fat/food/bodies/health(/"health") here on Kintsugi where both acceptance & diverse opinions are important.

 

Spoiler: Me me me

Background: I've got a big, low-income, middle-class family. My parents are both naturally a bit tubby and have pretty standard issues with food. (They think food=love. Or they used to; they're getting a bit better at that now.) One of my sisters is naturally thin, the rest of us have my parents' and grandparents' build (fat and active). Another of my sisters was anorexic/bulimic for years, unknown to me until about two years ago (at which point, some things fell into place). I don't think anyone else in the family knew either, including my parents.

I was a fat, active child; I'm now a fat, active adult. I spent years of my adolescence dragging myself out of the disordered eating hole through feminism and HAES, until I started getting to a good place with my relationship with food and my body. A few months ago I got diagnosed with PCOS, and the doctor made a big deal about the relationship between PCOS and weight gain*, how people with PCOS often gain weight easily and find it very difficult to lose weight, and that p much the only recommended treatment for PCOS is weight loss.

(Treatment of PCOS consists of the question: "Have you tried not having PCOS?")

I looked into HAES as it pertains to PCOS, and didn't find anything (weird, considering the commonness of the condition.) I've started exercising more frequently. I might have lost weight: I don't know, because I don't own a set of scales (hahaha no). Right now I'm doing my best to exercise for pleasure and clinging on to my hard-earned okay relationship with food. But I'm back in my parents' house for some of the summer holiday and I'm anxious about slipping back into disordered thought-patterns.

*He didn't seem very interested in me pointing out that I've had the same basic build my entire life, the same as all the women in my family, and haven't inexplicably gained a lot of weight at any point in my life as far as I can remember. But I don't really blame him. Poor bastard only gets 9 minutes per consultation.

 

I am here for this thread, theoretically, thank you for making it! :D

Like, exercising for pleasure? How? (I really love running and dancing and stuff but it's soooooo hard for me to do without automatic thoughts about weight loss/controlling my food intake and so on. And I stopped being technically bulimic five years ago.)

But! It's difficult to talk about because this stuff feels so shameful. I know none of my eating disordered thoughts are the least based in reality, but they still affect me so much! = I must be an idiot. And also super vain and self absorbed, to care so much about my body. Aaaaand I know thinking this way is incredibly unhelpful too. Sigh.

What I'm trying to say is that every time I try to talk about my own body issues I have to spend an hour going I KNOW. OK. I KNOW. YEAH, I KNOW THAT. OK. at my brain first and it's annoying.

Also: what is HAES?

 

@EulersBidentity I'm pretty sure the Shapely Prose archives have something about HAES and PCOS? I haven't read through most of the articles since it stopped making active updates though, so I could be wrong.

I also thought weight gain was a symptom of PCOS, not a cause. :T I get the feeling this is another one of the casualties of the "Fat is the cause of everything bad" bandwagon, and to hell with any data (like family history, good numbers on blood tests, and capacity to do physical things) to the contrary.

 

@smyxolotl These people can explain it better than I can ;) And yes! I've been looking forward to doing exercise, and trying really hard not to think about whether I am looking forward to it because I enjoy it, or whether it's because having gone for a run means I can stop thinking about it...

@Mercury re: symptom vs. cause. God, considering the way fat is considered in the UK, who even knows? Weight gain is a symptom of PCOS, so is increased insulin resistance (even in thin people, I think.) Weight loss, in theory, is supposed to ameliorate the other symptoms (e.g. amenorrhea, reduced fertility, increased chance of developing diabetes)...but how much of that is actually the case, and how much is that the people who already have less severe symptoms are able to lose weight...it's a mystery. I don't trust the NHS to differentiate correlation and cause, but I do appreciate the ridiculousness of being told "here are symptoms you can expect. Try not to have them, and you will be better."

 

Yeah, the medical system has had a really hard time separating out correlation and cause wrt fatness. Things seem to be changing now, but at an absolutely glacial pace. :|

I'm fortunate that doctors here in Finland mostly haven't harassed me about my weight yet, despite me having problems that a lazy doctor could try to pin on my fatness, but I've recently started Trying To Do Something About It, since through a combination of dysphoria, brainwrong, and needing a cane I was really reluctant to get, I got really physically weak and pudgier than I should be.

But it's become even more pressing because I got a warning that the endocrinologists who do the hormone prescribing thing for trans people only want patients to be a ~little overweight~ when they start T, because T increases appetite. And I'm like, of course T increases appetite, people starting HRT are starting a second puberty and their body is undergoing some pretty big shifts! I really resent the implication that's going to make me, like, start eating sticks of butter all day every day until I'm as big as a house.

Still, I know there's only so much my body composition is going to budge even if I magically exercised my crippled ass into athletic shape, since a certain level of of my fatness is clearly genetic (the two relatives I look most like had the exact same growth and weight gain patterns I did, despite all of us having wildly different lifestyles), so I'm pretty worried. I really don't want to suffer through the misery of being denied treatment and possibly falling back down the black hole of disordered eating I managed to struggle out of in my late 20s. I'm hoping that making it clear that I'm Making A Serious Effort will convince them that if I start HRT I won't in fact become an amorphous blob of fat in imminent danger of dying of a heart attack. e_e

 

There's a sense of being held hostage by the health service, I find. I don't want to fuck up my relationship with food or the equilibrium of my body. I do want to be able to rely on medical care that doesn't always fall back to the weight thing.

I'm glad your doctors haven't been too harassing about it! I was pleasantly surprised last time I went. The doctor started to go through the weight loss spiel but stopped when I pointed out that he'd explained it all to me the last time, that I'd started exercising more, and that I was much more interested in discussing the unrelated symptoms. He didn't even make me weigh myself, when I said I'd prefer not to.

(Sideline: I can't imagine being "a little overweight". I assumed I was "a little overweight", then I found out my BMI for the first time in years. I'm pretty sure it's not possible for me to healthily put myself in "normal range". With my build, I would have to lose a lot of muscle, and possibly a couple of bones. I had no idea how narrow the leeway is.)

 

oh gods, yeah. As far as I know, weight gain is not at all a cause of PCOS, rather a symptom, but the NHS insists you can solve everything with weight loss. (joint hypermobility? lose weight! fatigue? lose weight!) I really feel for you there. (I tend to remind people, really pointedly, that I have a history of anorexia and problems eating sufficiently to this day so their kind suggestions to eat less can fuck off and die in a hole be noted as clinically inappropriate. Though this is mostly for other conditions; I'm like 90% sure I have PCOS (all the symptoms and a family history) but I get dismissed enough that I just gave up and started taking the pill without breaks.)

 

Because what you definitely need at that point is to risk losing muscle which is supporting the joint...

Heh yeah, in practise my PCOS diagnosis went like this:
1st doctor's appointment:
"You probably have PCOS. You should talk to a nurse about how to lose weight."
"Nah."

*5 week wait*
*Anxiety-inducing ultrasound*
*4 week wait*

2nd doctor's appointment:
"You have PCOS. Do you want to go on the pill?"
"Nah."

(Also a great exchange with the doctor which went
Doctor: "Do you have [other symptoms of PCOS]?"
Me: "Well...not really. Not two standard deviations outside the mean."
Doctor: "What did you say your degree was, again?")

 

It's super narrow because it's ALL BULLSHIT. >:( idk if you know the story of how it came to be, but I'll find it for you if you don't. And they changed the standards in the late 90s, I believe, making the leeway even narrower and tossing a ton of people into the overweight category overnight.

Here's how dumb it is: the last time I was at the top range of 'normal' for my height according to BMI, I was emaciated from living off of one meal a day that consisted of noodles and olive oil, plus whatever blackberries I could scavenge from the bushes around town and the once or twice a month real meal a sympathetic friend would buy me, for five months. When my mom saw me again for the first time in half a year, a month after I'd gotten regular access to food again, she was horrified.

 

Yes!!!! 1930s insurance company, right? Or something like that.

Have you seen the photo project of people posting pictures of themselves along with their BMI category? I found it a while ago. Nice idea, but not really enough varied pictures to be really interesting.

 

BMI is crap.

Please don't believe it or take it into account at all.

 

Oh, it's even worse than that - it was invented in the early 19th century by a Belgian dude named Lambert Adolphe Jacques Quetelet, who was a mathematician. He invented the formula to provide a quick and dirty statistical measure to measure rates of obesity among the population - and, from what I've read about it, it's a pretty bad statistical measure. The only reason the forumla includes squaring a person's height is to make the numbers match up better.

I've seen it! It was cool but I agree, it needs more variation.

 

@hoarmurath I get that in terms of my personal view of my health, which is why I didn't bother measuring my weight or BMI until I was required to. For the first time in, god, six years? At least.

My concern is that the standards of medical care I can access will be affected by which arbitrary category I fall into, and I'm certain that at my fittest I'll never be in the "normal" category. There's nothing I can do about that, but it gives me the same kind of rage as "someone is wrong on the internet!" Heh. Don't know how to explain it otherwise.

Oh god. Mathematicians don't know shit about real life, and I say that as a maths student.

ETA: it is so reassuring to know that the most common scale by which we judge people's fitness was developed before antiseptic or germ theory

 

Makes sense. Personally I don't even want to know my BMI, I know it will be too big, because of my height and my weight.

I am sorry the doctors are being shitty. :(

 

Oh yeah! It was information I didn't ask for or need, and it didn't tell me anything about my own body that I didn't already know.

 

Oh damn I'm going to have to remember that to deploy as needed, that is an excellent point.

 

I'm really glad this thread exists. I have such conflicting feelings over this topic, because on the one hand, my mom's a health nut who just naturally loves healthy food, exercise, and dislikes "bad for you food". Nevertheless, she has screaming weight and body image issues, which I have hella fleas from. My dad is from a pretty heavy family, and is an amazing cook, so I associate food with comfort.

When I went home, my dad asked me to please consider eating better because his family has a lot of weight related illnesses that they're struggling with, and my dad is worried for me and my brother (who pretty fat). I put on some weight (idk how much, I don't have a scale) in my last year because depression made me unable to go outside and eating was super comforting. I also have autism sensory weirdness, and I get sensory bliss when I have a lot in my mouth at once. Which means I eat way too quickly, and then I eat too much.

I'm doing daily half hour walks with my SO now, and being very conscious of eating better food (hard on a budget) slower. But wow, is it hard. Plus I've got a lot of baggage from Mom's struggles with all that stuff. So I'm Just really glad this thread exists. ;-;

 

It was actually even better - I was presenting with complaints of severe joint pain caused by hypermobility. I can totally exercise the pain away! (Not in reference to physio, which might help once I get it, but just general calls to 'go exercise more and eat less'.)

Yeah, it is frustrating. I find it so both with the explicit 'lose weight' and the implicit lack of considering any diagnoses which would be considered in a skinny person with the same symptoms.

Also definitely 'someone is wrong in a doctor's office'. :P

 

I was a very thin child because I was iffy about food and very picky. I also had and still have absolutely attrocious levels of fitness. None of my gym teachers could ever accept that a 'thin child' could be so bad at running. Assuming fitness from weight is the most bullshit thign ever and it pisses me off.

Now I have a bit of a joint thing. Mainly they hurt. Like a lot. And feel like how unoiled door hinges sound. So somethign is wrong! But my bloodwork is being an ass and not displaying the value I'd need for a referral (despite all other symptoms pointing towards Something Rheumatic there is a health regulation pertaining those that I won't get a referral to a specialist without a sero-values cooperating. Joy.) And despite me saying that it hurts MORE when I move the joints, my GP wants me to exercise. Which, okay I get that it helps a lot of people and I probably SHOULD do something exercise-y, but like. Could he at least ACKNOWLEDGE my repeated reports that no, it hurts worse when I do literally anyhing more straining than walking at a brisk pace. And even that like. I spent five days walking at a brisk pace and hiking somewhat last spring. I was almost crying from pain by the end of each day. And that was ON PAIN MEDS which I was taking with breakfast literally everyday so I could get past lunch without breaking down. So there is pretty heavy evidence that exercise will not magically stop my deteriorating health from, well, deteriorating.