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AMA declares obesity a disease 
19th-Jun-2013 12:57 pm
So, the AMA has declared obesity a disease, which I guess means I have an extra diseases that I didn't have last week. Funny, I don't feel sick.

I've seen a number of folks applaud this decision by saying, "Well, at least now fat people can get the treatment they desperately want/need."

Which baffles me. Because for most of my adult life, my doctors have insisted on treating my fatness whether I wanted them to or not, often at the expense of what were arguably more urgent medical problems.

And the thing is, most doctors are pretty crap at treating obesity. Which in part is not their fault, because we don't have any good scientifically-validated ways of reliably getting more than a tiny percentage of people to lose weight and keep it off. Most doctors don't seem to be terribly aware of that.

Here are some of my favorite ways that doctors have tried to get me to lose weight:
* Threatening to withhold prescriptions for birth control pills unless I lost weight. (Because fat people don't deserve to have sex anyway? Interestingly and possibly non-coincidentally, they stopped pulling this shit on me after I got married.)
* Telling me to "drink more water" (Not horrible advice in and of itself, but at the time I would have had to lose 100 pounds to be "normal" on the BMI chart, so the idea that a couple extra glasses of water a day were going to get me there was pretty laughable.)
* Instructing me sternly not to butter my toast at breakfast. (Without bothering to inquire whether I ate toast, or even breakfast. At the time I habitually partook of neither. This was merely the most hilariously memorable of a general pattern of doctors telling me to eliminate certain foods or categories of foods, usually without bothering to check if I actually ate them. Notice that you can tell that this example was from the 1990s, because the dietary bugbear du jour was saturated fat. If the same thing had happened 10 years ago, the doctor might have been just as likely to tell me to skip the toast and eat the butter.)

Lest I tar the entire medical profession with the same brush, I should mention the rather wonderful nutritionist I worked with when I was in graduate school, who introduced me to the revolutionary concept that it was perfectly okay to eat when I was hungry, and who encouraged me to look at foods from the perspective of their total nutrients and overall effect on my health or mood rather than just calories. I didn't lose a lot of weight working with her, and it took several more years of going 'round the weightloss merry-go-round before I was able to fully incorporate everything she taught me into my daily life, but she actually gave me sane, practical advice.
19th-Jun-2013 09:56 pm (UTC)
All three of those things you list make me rage on your behalf. The third one strikes me as particularly nonsensical because unless you were putting a solid inch of butter over the entire piece of toast, I don't see how you would take in that many calories from buttering bread. >:p
20th-Jun-2013 04:10 pm (UTC)
Yeah, I know - a pat of butter only has 35 calories. No-Butter Lady was basically against fat in the diet - under her tutelage I experimented with dressing my salads with vinegar only, and with making sandwiches without cheese or mayo. I did lose a bit of weight, but it was a rather joyless way to eat.
21st-Jun-2013 05:34 am (UTC)
I don't have anything to add here other than general incoherent rage.

Funnily enough, medical professionals treat me better now that they perceive me as compliant in trying to lose weight.
21st-Jun-2013 04:32 pm (UTC)
Oh, god, yes. Even when doctors do want to talk to me about my weight these days, they do it very differently than the way they used to.

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