Tag Archives: Association for Size Diversity And Health

Six Year Old Girl Dies–Diagnosed as Fat?

Sorry to start your week out with such a sad story, but I think it needs to be told. Late last week I became aware of the story of Claudialee, a six-year-old girl who passed away after being misdiagnosed with type 2 diabetes, when she actually had type 1 diabetes. There is a very detailed account of the story here.

I’m not going to go into every detail of this story, but I did want to point out a few things that stand out for me. One is that Claudialee has a family history of diabetes. Another is that the doctor diagnosed Claudialee as obese. It is clear that the doctor was deeply concerned about the young child’s weight–prescribing diet and exercise in an effort to get her to lose weight. It is also clear that the mother closely followed the doctor’s recommendations–carefully monitoring what Claudialee ate and making sure she got plenty of exercise.

What is not clear is why the doctor felt so strongly that this child had Type 2 Diabetes as opposed to Type 1. According to a source cited in the article (The National Institute of Health) at that age group, Type 1 Diabetes has an incidence of about 20 in every 100,000 kids, whereas Type 2 Diabetes has an incidence of .4 in every 100,000 kids or 1 in every 250,000 kids. What’s more, at that age, Type 1 Diabetes is a far more urgent problem than Type 2 Diabetes. So what led to the doctor’s misdiagnosis?

We may never know for sure. But it does invite one to speculate whether the child’s weight was a factor. Clearly, getting Claudialee’s weight down was a prime part of the prescription to the parent. And as the child’s weight went down, the doctor neglected to do some of the critical follow-up blood tests that would have indicated that something was drastically wrong.

The article states:

Because Mercado [the doctor] had locked in on type 2, she did not monitor her patient’s blood. She did not tell Irma [the child’s mother] to purchase a $20 blood sugar meter from the drugstore. She did not ask Irma about the frequency with which her daughter drank and urinated. And neither she nor Cabatic [another doctor] described to Irma the danger signs to look out for.

When asked in court, why the doctor seemed so certain that the child had type 2 diabetes when type 1 diabetes was so much more prevalent among children that age, she stood by her original diagnosis:

“How many type 2 infant diabetics have you treated?” a lawyer asked her.

“A lot,” she replied. “Maybe it’s geographical, because I work at Brooklyn as an assistant professor and also in wellness program where there are a lot of obese children, so we diagnose a lot of children with type 2 diabetes.”

Clearly there may have been other issues at play here. Claudialee was on Medicaid and doctors are paid significantly less for treating patients on Medicaid than they are for those with private insurance. The doctor was not board-certified, and the article points out that finding board certified physicians willing to work in clinics that take Medicaid can be difficult. And this is a single case where a single doctor has been convicted of malpractice. We will never know exactly what was in the doctor’s mind.

I but I personally found myself wondering if this doctor had ever previously considered that she may have a bias against fat patients–and maybe even fat children with low SES in particular. I wonder, had this doctor considered the potential for her own bias in this arena, would that child still be alive? Would Claudialee still be running around and playing today?

We certainly have plenty of evidence for a seeming “hysteria” around the issue of childhood Type 2 diabetes. A simple google search of “childhood diabetes epidemic” yields hundreds and hundreds of articles. This hysteria has spawned a number of shaming techniques aimed at children despite the fact that shame has been proven over and over again to be ineffective at treating obesity at any age, that shame is more likely to make kids engage in unhealthy behaviors, and that eating disorders are much, MUCH more prevalent among children than diabetes of any kind.

All I know for sure, is that stories like that of Claudialee get me even more fired up to fight against weight stigma in medicine. And that passion leads me to come to you with a plea. The Association for Size Diversity And Health and the Size Diversity Task force have embarked on a documentary film project to help doctors see and understand weight stigma and weight bias in medicine. This project is called the Resolved project. But this project needs a little bit of help from you. We are raising funds to finish the documentary on Go Fund Me here. Any help you can offer would be greatly appreciated. Even if you can only give a few dollars, that will help. And if you don’t have a few dollars to spend, would you consider sharing this with your friends and asking them to help? Let’s see if we can end weight stigma and weight bias in the healthcare industry for good. And maybe, just maybe we won’t have stories like Claudialee’s any more.

Love,

Jeanette (The Fat Chick)

P.S. Want to stay up to date on my projects and appearances? Just opt in RIGHT HERE!

Our Big Fat Community

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Working out at the ASDAH conference

Over the past week, just after my return from ASDAH’s very successful conference, I have seen a number of additional examples of our Amazing Big Fat Community in action. One event that drifts up to the top of the list is the Big Fat Flea Market hosted by the Size Diversity Task Force this past Saturday. I mean HOLY COW! We had tables upon tables of rad plus-sized clothing, we had 74 gorgeous, brand new corsets donated by Hips and Curves and over 1,000 of donated raffle prizes by size positive businesses including Amplestuff, The Butterfly Lounge, Club Bounce, Chair Dancing, Dances With Fat, Elle Hill, The Fat Chick, Hips and Curves, Igigi by Yuliya Raquel, Kiyonna, JW Assists, More of Me to Love, Size Queen Clothing and more…

It was a lot of work, but it was also an awesome opportunity to get together and support one another. And via facebook, twitter and live streaming we were also able to virtually shop for people who lived too far away or weren’t able to make it to the sale in person. We packed several boxes of fabulous finds for our remote buyers.

And by the way, if you are anywhere near the Pasadena area, I happen to know a LARGE influx of plus-sized clothing just landed at the Goodwill at Hastings Ranch at 3801 E. Foothill Blvd.
Pasadena, California 91107.

Ragen Chastain has also started raising funds for a very exciting documentary project called In Our Own Words, A Fat Activist History. This is an unprecedented opportunity to help preserve the history of the size acceptance movement and understand those who have paved the way for the current activists like Ragen and I to do our work.

I was also overjoyed this past week that ALL OF YOU helped to put my book, The Fat Chick Works Out!, on Amazon’s best-seller list. I want to offer my sincere thanks to all of you for helping to make my work more visible and more accessible to everyone who might need it.

I’m not listing all these things to brag. (Well I am bragging, but that’s not the only reason). I’m listing these things to remind you that there is a community of people out there who are actively trying to make the world a better place for people of all sizes. This community does its work in a variety of ways. From media interviews to fund-raising to helping somebody in a remote town find some gently-used, gorgeous clothing that they can afford. Which leads me to this important point: this movement needs you.

Not everybody can devote their entire life to the size diversity movement, but we can all give something. Even if it’s simply donating a few dollars to the Size Diversity Task Force for their upcoming build of the world’s largest paper mache sculpture composed entirely of recycled diet books. Maybe it’s simply joining the Size Diversity Task Force or ASDAH or the Fit Fatties Forum or The Fat Chick Clique. Even if you can’t donate cash, can you spend a few seconds each day sharing important size-positive posts on Facebook? Can you reach out and leave a few encouraging words in the comments section of a size-positive blog? Can you suggest resources or lend support to somebody who is being flamed online for daring to post or share size-positive viewpoints?

Which leads me to another important point: you need this movement. Whether you are fat or thin, tall or small, size discrimination and fat shaming hurts all of us. It can be really tough out there in the world and we all need friendship and support. And even if you live somewhere remote, where you may have trouble finding a way to physically meet with some of these groups, most of them have digital counterparts where you can connect via the computer, your phone or even good old snail mail.

So I’d like to encourage you to spend just a few moments thinking about a way that you personally, yes you, can reach out to the size acceptance community. Join ASDAH, or the Size Diversity Task Force or The Fat Fatties Forum or The Fat Chick Clique. Connect with one of these organizations via Facebook or Twitter. Donate to Ragen’s documentary project. You make the world a better place for other people of all sizes and you make the world a better place for you. And you’ll look fabulous while you’re doing it. That’s what we call a win-win-win situation!

Love,

The Fat Chick.

Like my posts? You’ll love my stuff!

Buy my book: The Fat Chick Works Out! (Fitness that is Fun and Feasible for Folks of All Ages, Shapes Sizes and Abilities)–available in softcover and e-book versions

Buy my DVD: The Fat Chick Works Out! (A Safe, Easy and Fun Workout for Klutzes, Wimps and Absolute Beginners!)

Buy a book or a DVD for a friend and save $5! Just enter FRIENDBLFT in the discount code box!

Check out my Training Programs–both in person and via Skype (Starting at just $25!)

Book me to speak at your special event!

When doctors are wrong.

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I recently watched this video–a TED talk–by Dr. Peter Attia. You may have seen it as it’s become quite a viral sensation over the last few weeks. But even if you have seen it, you might find it useful to watch again. So here it is:

While I don’t agree with absolutely everything Dr. Attia has to say, I do think he brings up a few important points. One issue is that some doctors, scientists, and other medical professionals are really starting to question the causal nature of the link between obesity and diabetes. I think this is an important area that will require a lot more study. And I think it is our job to continue to push for this continued study.

But one issue that I want to particularly want to highlight here is how hard it seems to be for doctors to admit they are wrong. Dr. Attia is clearly deeply moved. He feels a tremendous sense of remorse for how he treated that poor woman with diabetes. Once he realized the level to which he had allowed stigma to affect his treatment of this woman he was devastated.

Many of us would be quick to state, well he should be. He may have deeply hurt this woman. He may not have given her the best medical care. Many of us don’t go to the doctor because we are so afraid of being hurt just this way at the doctor’s office or the hospital. Some of us have died because of this.

To which I would respond, “Yes, that’s true.”

But I think it’s also important to see what this video has to teach us about doctors and what it might be like for them to understand that they were wrong about something. We look to doctors to fix everything. We ask them to make us well and to bring us back from the brink of death. It takes a certain amount of arrogance to hold a person’s beating heart in your hand and endeavor to fix it. And I imagine there is a certain amount of pain when you have to tell somebody or tell their family that you can’t fix it. You can’t make it all better. You are not god. And I’m not sure that the pain ever goes away.

Please understand. I am not making excuses for doctors who bully and stigmatize fat people. It is wrong, and it needs to stop. Now. That is why I am working so closely with the Size Diversity Task Force and the Association for Size Diversity And Health on the Resolved project. We need to share our stories. We need doctors and the public to understand that weight stigma is extremely damaging to fat people in medical settings and is sometimes even fatal. There was a period of years in my life when I was quite sick and might have died based on the assumptions that doctors had made about me. So I get it. This must change.

But I think, if we want our work to be effective, if we want things to change, we need to be perceptive and understand what it means to help doctors understand that they are wrong about this. We need to understand this–not so we can let them off the hook–not so we can let them down easy– so we can find the best path towards an actual solution, so we can understand why many doctors are so resistant, and so we can better understand why this is taking so long.

The issue of weight stigma in medicine is complex and nuanced. But I do know one thing. It will only change if a lot of us continue to work together to bring about change. I would love to hear your thoughts about this issue. And I would love to have your continued support to make the Resolved project a success! Click here for more information about how you can participate.

Love,

The Fat Chick

Like my posts? You’ll love my stuff!

Buy my book: The Fat Chick Works Out! (Fitness that is Fun and Feasible for Folks of All Ages, Shapes Sizes and Abilities)–available in softcover and e-book versions

Buy my DVD: The Fat Chick Works Out! (A Safe, Easy and Fun Workout for Klutzes, Wimps and Absolute Beginners!)

Buy a book or a DVD for a friend and save $5! Just enter FRIENDBLFT in the discount code box!

Check out my Training Programs–both in person and via Skype (Starting at just $25!)

Book me to speak at your special event!

The Right Now Show Episode 009: Finding Support!

Right Now Show–Episode 003: Healthcare and YOU

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In episode 003 of the Right Now show, we explore the new initiative by the Association for Size Diversity And Health (ASDAH) called RESOLVED: addressing weight bias in health care. Jeanette DePatie (AKA The Fat Chick) shares some stories about her journey in healthcare and shares details about the RESOLVED project with the viewers.

For more information about the RESOLVED project, go to the ASDAH website. And to read another story about a truly frightening misdiagnosis of a fat person, click on THIS LINK.

And finally, if you’re enjoying the show, don’t forget to subscribe at: http://www.youtube.com/jeanettedepatie.

Thanks so much!

Love,
Jeanette
AKA The Fat Chick
http://www.thefatchick.com

P.S. This marks my 365th blog post! (One whole YEAR of blog posts=YAY!)

Don’t forget to enter your miles in the Fit Fatties Across America page on the Fit Fatties Forum. Let’s see if we can get out of Colorado and a little further down the road!

And if you’d like more information about how to pick a doctor that’s right for you, there’s a whole CHAPTER on that subject in my book The Fat Chick Works Out! You can buy a hard copy or an e-book, whichever you like!

What is Health?

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One of my regular readers recently sent me a question about how I define health. She was particularly interested in my definition, as she felt that most if not all of the definitions of health out there in the world either would not or could not include her.

First and foremost let me tell you that I think there is no such thing as perfect health. There is no specific state of being that you can achieve, there’s no moment that comes with achievement badges and a certificate that marks “health”. But let’s take a moment to discuss some of the definitions of health already floating around out there.

Now let’s take a moment and consider some other definitions of health. Here’s the World Health Organization definition of health:

Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.

Now the WHO definition does take the ideas of mental and social well being into account. So, it scores points for that. But it also implies that these things are in addition to the complete absence of disease or infirmity. It also implies that health is a state of complete well being. Now under this definition of health, i may have achieved that on one particular day, when I was 19. I think it was a Tuesday. But I think this is an “idealistic” view of health that leaves a lot of people who are dealing with chronic disease or infirmity with the idea that health is not possible for them. Which sucks. So why bother?

Needless to say I think this definition leaves something to be desired.

The Association for Size Diversity And Health has this definition of the principles of Health At Every Size(R):

1. Accepting and respecting the diversity of body shapes and sizes.

2. Recognizing that health and well-being are multi-dimensional and that they include physical, social, spiritual, occupational, emotional, and intellectual aspects.

3. Promoting all aspects of health and well-being for people of all sizes.

4. Promoting eating in a manner which balances individual nutritional needs, hunger, satiety, appetite, and pleasure.

5. Promoting individually appropriate, enjoyable, life-enhancing physical activity, rather than exercise that is focused on a goal of weight loss.

And this definition is far better. It promotes a series of behaviors and principles as opposed to an arbitrary standard of physical indicators or an unattainable ideal of perfect well-being across a spectrum of categories. I actually really like the HAES(R) principles as spelled out by the Association for Size Diversity And Health a whole lot. But I also understand that as opposed to the WHO definition, it’s a little long and ponderous.

So how do I define health? I’m not sure that my definition is better than either of those listed above–it’s just the way I personally see it. I think health is one end of a personal continuum that is completely unique to each of us. We do not achieve health. We move towards health or away from health in our own lives. When we move towards health, we engage in behaviors that give us a better quality of life and give us more energy and capacity to do and enjoy the things that are most important to us. When we move away from health, we engage in behaviors that rob of us of energy and give us less capacity to do and enjoy the things most meaningful to us. All the while, we must take into account that there are aspects of quality of life outside of our control. We are imperfect beings who age and die. This is a fact of life. But the pursuit of health, is the process of discovering for ourselves, what behaviors allow each of us to make the most of the bodies that we already have to experience and attain that which means most to us from day to day.

Which is also very long and ponderous. So here’s my shortcut version:

Moving towards HEALTH is the process of using the body you already have in a way that allows you to best enjoy and or/attain the stuff that matters to you most.

I’m not a doctor or a philosopher. But those are my thoughts. I hope you are able to find what health means to you on your personal continuum and move towards it in a way that feels wonderful.

Love,

The Fat Chick

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