Tag Archives: bulimia

Teenage Boy “Diagnosed Fat”–Infection Missed

chart2How many times have we heard this same story?  A vibrant, active young man goes to the doctor, in this case, with knee pain.  The doctor does a routine test and doesn’t see a problem.  The doctor does see a young man who fits into an “undesirable” segment of the BMI chart.  The solution, the young man is diagnosed as fat, is told that his “extra weight” is probably causing the pain in his knee and sent home.  Now Kaleb is an active kid.  He plays rugby, and he loves to sail.  But once the doctor sees Kaleb’s place on the BMI scale, he just might think something like this: “Aha!  I don’t have to say that I don’t know what’s wrong with this kid’s knee.  I can write obesity in the kid’s chart and then we have a diagnosis!”

Unfortunately, in Kaleb’s case there was another diagnosis besides “fat” to be found.  A short while later, he was taken to the hospital via ambulance after he fell down some steps.  At that point, he was referred to a specialist that he saw two weeks later.  The specialist ordered an MRI and during the scan they found a serious bone infection.  Kaleb was scheduled for emergency surgery the same night.  He is recovering well.  So thankfully, the story has a happy ending.

But how much pain could have been avoided without the “fat diagnosis”? It appears that had this infection been detected earlier, it could have been treated with antibiotics rather than emergency surgery.  Now there’s no guarantee that had Kaleb been thin, they would have found the infection sooner.  They might have still sent him home and told him to take some aspirin and take it easy.  Thin people are misdiagnosed too.  But I’ve heard time and time again about people who are “diagnosed fat” and sent home.  Remember this guy who was diagnosed fat, and it turned out to be a brain tumor?  Remember his emergency surgery?  I wonder if doctors, frustrated by a lack of diagnosis and discouraged from ordering expensive tests don’t lean on the BMI chart as a way to have something to write in their diagnosis box.  I imagine in many cases, once patients are “diagnosed fat” and are shamed and blamed, they stop asking annoying questions.  They stop demanding that doctors figure out what is wrong with them.  In some cases, they stop going to the doctor altogether.  This is part of the collateral damage and opportunity costs in the “war on obesity”.  This is another example of the casualties that arise from singling out a body type as unacceptable and trying to eradicate it.

And we’re not just dealing with misdiagnosis here.  We’re dealing with fat people suffering and dying from the mutilation of otherwise healthy tissue via gastric bypass and banding surgeries.  We are seeing the development of more and more new strategies for trying to make fat people “healthy” by making their digestive systems mimic eating disorders and limited blood flow to the gut.  We are so focused on helping fat people get healthy by making them thin that we are willing to make them really, really sick to help them get there.  And sadly, in so many cases, the fat people who undergo these treatments end up fatter or sicker or less happy than they were in the first place.

There are weapons we can use in this war.  One of them is to ask the doctor if thin people also experience the same problem.  In Kaleb’s case, he or his mom might have asked, “Do thin people also have knee pain?  What tests might you do if I were thin.  Can we do those tests please?”

Another weapon is to help make doctors and other medical professionals more aware of the pain and repercussions of fat bias.  And it just so happens that we have some terrific tools to do that.  The Association for Size Diversity And Health (ASDAH) along with the Size Diversity Task Force are compiling videos about fat bias in healthcare.  The project is called RESOLVED.  Some folks at ASDAH have informed me that the deadlines are being extended.  You can hear more about the project and see my sample video HERE.  In addition, the Size Diversity Task Force has a unique opportunity through one of our members to help train medical advocates about fat bias in healthcare.  But in order for your video to be used in both places, you need to submit your video by March 18.  If you’re interested in participating in the project and/or have any questions or concerns, please leave me a note in the comments below.  Or send me an email at jeanette at thefatchick dot com.  I’d be glad to help.

Let’s do what we can to limit the number of casualties in the war on fat.  Let’s help kids like Kaleb get the attention and care they need at the first doctor’s appointment–not the third.  Let’s see what we can do to have “diagnosed as fat” be a thing of the past!

Love,

The Fat Chick

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Trigger Warning: Why an At Home Stomach Pump Might Not be Such a Good Idea

happytummyOkay, what I’m going to talk about today amounts to potential corporate backed, government sanctioned bulimia.  And it has a pretty major “ick” factor as well.  So if either of these things are triggering to you, you might wish to go back to Thursday’s post with the dancing bird.  I’m totally cool with that.

But there has been a flurry of articles and emails flying around about a firm that wants to tackle obesity by offering what amounts to an at-home stomach pump.  I know.  It sounds like an article from The Onion.  It sounds like a really badly thought out skit on Saturday Night Live.  I even checked Snopes.com  But unfortunately, it appears that this is real.

Wired magazine recently published the article, “US firm wants to tackle obesity with at-home stomach pump.”  In the story, they explain that a US company (ASPIRE BARIATRICS LLC) has filed for a US patent for “Apiration Therapy” which is intended to be “a non-invasive alternative to gastric bypass.”  Basically what happens is the patient has outpatient endoscopic surgery in which a tube is installed in their stomach that pokes out a very small incision in the center of the abdomen.  Once the incision heals, the tube is trimmed flush with the patient’s body and a “skin port” is installed.

The patient is then encouraged to regularly pump the contents directly out of their stomach.  Let me explain exactly what this means.  (And I’m offering an additional trigger warning right here.  Thursday’s dancing bird was super cute…)  Here’s a quote from the “study”

She “aspirated” after every meal: “the patient uncapped [her] tube, connected a 60 cc syringe and extracted food from her stomach twice. This resulted in a siphon effect, which permitted the subject to freely drain the stomach by allowing the open tube to empty into a bucket. The patient squeezed the tube to enhance propulsion and to break up large food.”

 

Okay.  So you eat a meal.  And then you connect a syringe to your “skin port” and create a “siphon effect” which “freely drains” your undigested stomach contents into a bucket. Apparently by doing this and drinking water between each aspiration, the dieter was able to evacuate between 2 and 3 liters of fluid after each meal.

Let’s just stop right there, shall we?  Just HOW can anybody think that this is okay?  How, exactly are you supposed to have anything approaching a normal life with this treatment?  After each meal, you have to attach a syringe and engage in a multi-stage process, during which you drink several liters of water and dump your raw stomach contents into a bucket.  How can THIS be a good idea?

The reason I am telling you this decidedly disturbing story is not simply to gross you out or titillate you with gory details.  (Although I have no doubt that both of these play a part in why the story was originally published).  No, I want to use this story to illustrate a few very important points.

1.  Our society makes people desperate to lose weight.  Fat people face constant messages that they are sick, lazy, gross, unworthy and useless.  Many are harassed by strangers in pubic places, derided by doctors, passed over by potential employers and face daily abuse by strangers and loved ones alike.  Fat people who have internalized these messages or are worn down by the constant abuse may become desperate.  They are desperate enough to have irreversible surgery done to alter the functioning of healthy organs.  They may even be desperate enough to siphon their stomach contents into a bucket.  But is the real problem here the fat, or the desperation that our world inflicts on fat people?

2. This patent application was filed based on a single study of 24 patients who, best I can tell, have been followed for less than two years.  Now it’s important to note that this invention has NOT been approved by the US Food and Drug Administration.  But given some of the folks involved in this project (including Segway creator Dean Kamen who co-invented the prototype) it is likely to move rapidly in that direction.  Can we just note the situation here where we had a guy who invented a product that keeps people from having to walk anywhere also inventing a bariatric product?  Anybody else see a contradiction here?  And while many weight loss schemes and products seem to work well in the first year or two, they all seem to have considerably less success at the 3-5 year stage.  What reason do we have to believe that this process would be any different?

3.  The purpose for the product as stated in the patent application is “The present invention is less invasive than current surgical procedures for reducing weight and allows patients to live a normal and active lifestyle without experiencing adverse side effects.”  Just exactly how normal is it to spend more than 20 minutes several times per day emptying food out of your gut into a bucket?  It is interesting however that the patent application does not cite any potential health benefits of the product outside of the “normal and active lifestyle”.  This may be because with their extremely limited sample size and study duration they weren’t able to record any.  Or maybe they just feel the health benefits of weight loss are something that “everybody knows” about.  Or maybe it’s because we’re finally realizing that the health problems associated with overweight and obesity may have been blown out of proportion.

4.  How is this not medically induced bulimia?  Whether you regurgitate your stomach contents or squeeze them out of a tube, it basically amounts to the same thing.  Sure, you may have less damage to tooth enamel and esophagus from the tube method, but it seems likely that many of the problems of malnutrition as well as the damage of the binge/purge cycle would apply here.  Maybe dealing with fat by creating a systemic, medicalized eatiing disorder is not the way to go here.

5.  It’s about money.  The prototypes were created, the medical trials were completed all at what had to be enormous expense, because there is a tremendously huge amount of money at stake here.  Gastric bypass surgeries seem to be waning in this down economy as stories of corruption, and more and more information about long term side effects and reductions in efficacy come to light.  Bariatric medicine is looking for the next “big” thing that will allow them to make a lot of money.  You can bet this project will be fast-tracked.

Okay, this post has already reached epic length and I should probably wrap this up here.  So here’s the bottom line.  Do we want to live in a world that is so emotionally toxic to fat people that they will do anything to lose weight?  Do we want to live in a world where the health benefits of intuitive eating and regular moderate exercise are pushed aside in a mad dash to create stunning “before” and “after” pictures and to line the pockets of bariatric medical establishments?  Or do we want to choose something better for ourselves and for all of our brothers and sisters of all sizes?

I don’t know when or if this product will ever come before the FDA.  I do know that in the mean time, I will continue to work towards a HAES (R) approach to wellness.  I know that I will work for health and well being for people of all sizes that is based on sound science, dignity and self-respect.

Love,

The Fat Chick

Lady Gaga’s Response to Body Comments

Yesterday’s post was all about how bodies don’t come with a comment button, and that we are under no obligation to make our bodies look the way other people want them to look.   As you might guess, if ordinary people feel pressure to comply with societal standards about visual appearance, celebrities also feel a great deal of pressure.  That’s why I was somewhat excited to read about Lady Gaga’s response to the recent uproar about her “getting fat”.

Recently some photos and nasty articles were released that showed Lady Gaga looking a lot heavier than before.  There is a lot of discussion about the apparent distortion of these pictures, making Gaga appear shorter and heavier, being caused either by squishing them in Photoshop or because of the flattening effect of certain camera lenses.  In other photos and videos from these exact same appearances, Gaga looks notably thinner.  However, Gaga readily admits that she has gained about 25 pounds.  She says that she is “dieting now” and that she has gained weight because “she loves to eat” her Dad’s amazing Italian cooking.  But before you start wondering why I’m talking about her on my blog let me share with you that she also states, “I really don’t feel bad about it, not even for a second.”

Yesterday, Gaga shared on her site, LittleMonsters.com that has been dealing with anorexia and bulimia since she was 15.  She also included some photos of herself (with her eyes closed) wearing just a bra and panties.  And she launched a new subsection of her site called the BODY REVOLUTION.  Some copy on the new section reads:

My mother and I created the BORN THIS WAY FOUNDATION for one reason: “to inspire bravery.” This profile is an extension of that dream. Be brave and celebrate with us your “perceived flaws,” as society tells us. May we make our flaws famous, and thus redefine the heinous.

She also popped up this past weekend in Paris wearing this dress.

Now don’t get me wrong.  I can’t hold Lady Gaga up as an unflinching paragon of size acceptance.   Not that long ago she was criticized for her “pop stars don’t eat” twitter post.  One might wonder whether the photos in her undies are as much about proving her relative thinness as they are about revealing her soul.  But I do think she’s trying to shine a lens on the ugliness of body snarking and the intense pressure girls and women face to be thin.  And I think in revealing her lifelong struggles with anorexia and bulimia, she is admitting that she doesn’t claim to have all this body stuff figured out.  It’s a process.  It’s a challenge.

But I am excited that at least part of what has come of all of this is one of the pop icons of our times inviting fans to embrace themselves as they are on her site stating:

Hey Guys its Gaga… Now that the body revolution has begun, be brave and post a photo of you that celebrates your triumph over insecurities.

Time will tell whether this movement towards body acceptance will stick with Gaga or drop along with her 25 pounds.  She may stay on this path.  She may be hawking weight loss products in six months.  I don’t know.  But it’s hard not to see that all celebrity bodies seem to come complete with a comment button.

So my little Chicklettes, can we take some good from this?  Sure!  First, let’s note that some of the “sexiest” and “most popular” women in the world struggle with body image.  And while I wouldn’t begin to compare your struggles with the struggles of anyone else, it’s good to know that we all have those struggles in one way or another.  Next, let’s take a minute to celebrate your triumphs large and small over body insecurity.  And finally, I’d love for you to remember that wherever you are on your journey to body acceptance, we are all works in progress.  Nobody is perfect at loving himself or herself.  But with gentleness and kindness we are on our way!

Love,

The Fat Chick