Tag Archives: medical 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

I want to be the chubby mouse with the big fat brain.

Isn’t it interesting how so many people who have never met us are nevertheless quite sure they know exactly what we want? I have been inspired by a number of amazing posts by fellow HAES experts this week that talk about the notion that no matter what the cost, we all want to be thin.

It all started with Ragen Chastain’s amazing post about the notion of having a “fat brain”.  She talks about the various “experts” she’s run into who promise that being fat is simply a state of mind.  These experts tell us that if we just get our mind right, we’ll be thin.  And I have to state, I’ve run into a fair share of folk who have suggested the same thing to me.  I remember sitting through a lecture during one of my fitness certifications where the leaders decided to go off book.  They drew a stick person on the board with a hole in the center.  They said that fat people eat because they have a hole in their lives that they need to fill with food.  They suggested that once these poor fat folks figured out where the “empty spot” was and learned to fill it with something other than food, they would be thin.  I wish I could say that I stood up at that moment and asked the leaders where the “hole” was in my fat body, because I sure couldn’t see it.  I think I was too angry and freaked out to stand up at that moment.  (And in retrospect, maybe asking a fitness instructor to help me find my “hole” wasn’t such a good idea after all.  And in light of the proposed medicalized bulimia apparatus a new “hole” may wind up in the future of quite a few fat folk.)  I seethed the entire weekend and ultimately wrote a scathingly bad review and called the district supervisor.  But the message of these misguided teachers was nevertheless quite clear.  I had a fat body because I had a fat brain.  And nobody wants a fat brain, right?

Except, I kinda do.  Because you know what? Brains are made up of mostly water and fat.  And we can argue on and on about the type of fat that is in our brains.  But no matter how you slice it, a scrawny, skinny brain is not the very best for thinkin’. I like my fat brain.  In fact, I might even want to plump that bad boy up a little.  So score 0 for the folks who felt quite confident they could read my chubby little mind.

On to the next cyberbump on this topic, this time delivered by the always amazing Dr. Deah Schwartz.  It seems she was pretty upset about the last line found in this article discussing how endocrine disruptors have been shown to cause obesity in mice.  The article begins with a picture of two mice–one skinny and one fat and ends with the line, “After all, which mouse would we rather look like?”  Clearly the author believes that no one would rather look like the more rotund rodent.  Just like nobody could possibly want a fat brain.  Except, I’m not so sure.  I think the tubby mouse actually looks a little cuter.  And since this mouse study seems to indicate that mice who are on a diet seem to be depressed all the time, I think I’d prefer to look like the fluffier little fella.

Look. If you wanna be my lover (or friend or collegue), don’t assume you know what I want.  Don’t assume that I am eager to meet your aesthetic standards for the way I look or what I eat or how I hope to be.  If you want to know, ask.  Then I’ll tell you what I want what I really, really want.  The answer just might be something completely different than you originally thought.

Love,

The Fat Chick.

P.S. Tune in to the blog tomorrow for the next episode of my new YouTube show: “Right Now! with Jeanette DePatie (AKA The Fat Chick).  And don’t miss the telesummit I”m doing with Anne Cuthbert tomorrow about setting safe, healthy and happy exercise goals.  And finally don’t forget to add your minutes and miles to the Fit Fatties Across America form.  Help us get all the way to San Jose in time for A Fatty Affair on Saturday!  We’ve got 1,300 miles to go, so enter your time and your miles today!

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