I use this title because I feel its important to point this out. I’ve dealt with health care workers in various forms, and all I can say is this: Nurses are the ones who actually care.
The women I work with here are far more likely to say less about my weight and more about how pale I look, how tired I look. They are more likely to ask me if I am stressed out. And I am sure that to them, weight loss or gain is a sign of something else.
Working with these RNs and masters of nursing has taught me that those who actually care about your health can and will talk to you about it in a way that reminds you to care about it too. Yes, sometimes they will scare you, such as when my boss told me that anemia can kill. But since I am and still can be very remiss in taking my iron supplements, she whipped out the scare tactics at the right time and over the right issue.
I haven’t always been happy with the way my doctors have dealt with me in terms of my “weight”… as a child especially, my doctor at the time wanted me to be on a diet (which I think is pretty much the WORST thing to do to a child) and regardless of a lack of proof of other actual health conditions, my fat was bad.
End of story.
Unfortunately, I’ve also had my fair of recliner physicians, like the wife of an old friend, who, because she was studying radiology at the time, told me that this UC Davis study must be bullshit and then started to quote diabetes and heart disease statistics.
I wasn’t aware that radiologists had such extensive training that they are qualified to evaluate health in such a way. It was a shocker… so that’s exactly what I told her.
That was probably my first real act as a fat activist: Telling that one single person that she is literally spouting biased opinions, obviously, BECAUSE THE STUDY I AM TALKING ABOUT SAYS DIFFERENTLY!
And if that isn’t an inherent trait of the bigot (the promotion of skewed ideas as “truth” even in the face of real but contradictory evidence) I don’t know what is.
I am pretty sure the crux of the problem that the UCD study leads to is dependent on our push for a different world view. After all, no sooner is the statement made then it is suggested that doctors talk to their slightly overweight patients about the “known negative effects of these conditions on mental and physical functioning, rather than on an increased short-term risk of death.”
I’d love to see what the “known negative effects on mental and physical functioning are”. After all, I’ve been fat for a long time. I think I would have noticed if it had made me stupid or caused some other mental impairment. The long term effects on my physical functioning aren’t conclusive either, since everything I suffer from can be suffered by those whose bullshit medical instrument is much lower than mine (that’s going to be what I call it from here on out… it doesn’t deserve to be respected with it’s name, BMI, spit spit on it).
Anybody here that can say differently? Has anybody here actually been able to determine that FAT ALONE is what has caused some kind of slip in brain functioning or mood? I can tell you, those who say fatness causes depression don’t seem to understand that it only does so through the lens of social disdain.
And as far as impairing physical functioning… well, that is more related to diet than actual fat. Yes, eating too much refined sugar is linked to type II diabetes. Yes eating food that is too rich in bad cholesterol can cause blocked arteries.
It’s sad that the medical community doesn’t seem to be able to do what is right, which is to just leave off the bit about “weight gain” and focus on the real danger, which is a danger to everyone: Our society is food fixated and all the attention is turned toward crap. Eating crap your whole life WILL kill you, regardless of whether you or thin or fat.
That should be the only message that is sent, that all things considered, weight gain, if it is mentioned, should be done so in small amounts, under all the other EFFECTS of a poor diet, but should not come before or somehow act a direct cause of diabetes or heat disease.
I say this because I have seen very thin men eating burgers made up of half-pound patties of meat. A part of me wishes it was easy to bet them money that my cholesterol scores are BETTER than theirs, since I try to stick to a diet that is diverse in nutrients. I try to eat various kinds of vegetables, various kinds of fruit, some diary, mostly white cheese and cream for my coffee, lots of whole grains, beans, legumes and smaller amounts of poultry and fish.
It seems to be working too, because the number they gave me for good cholesterol is twice is as high as the one for bad. I’m no doctor, but that sounds like a very good thing.
Boy have I digressed. I guess if you are a follower and actually reading this, you are probably used to the bouncing around, tangential way I write. I talk that way too.
My friends joke that because of this, most of them actually know another language: Christine.
Anyway, if I was given a choice between talking to the doctor who was interviewed for that story about the Davis study or talking to my boss about my health problems, I’ll take talking to my boss.
Mostly because she and so many other nurses I have met have a straight-forward attitude toward symptoms, causes, and treatment. These are women who I can tell “I am stressed” and they will not automatically assume that it is somehow caused or can be treated by weight loss. Instead, they will simply say: What are you doing to fix it? They will say, are you taking your iron, are you sleeping, have you tried a white noise generator? What are you doing to try to take the stress off your system.
I think I’ve figured out why this is. A part of the course work of nurses, which I have picked up while working out here, is to learn the way nurses prioritize aspects of patient care, and give their own “diagnoses”. Although I am pretty sure that that term is used differently among nurses than it is among doctors.
Doctors hand out large diagnoses that are very narrowly focused. I read this blog post (Just Add Connection) and found myself thinking of medical science, in this case, the scientific investigation of nutrition, in a new way because of one simple principal which I can see is necessary to scientific inquiry: scientific reductionism.
I suspect this is the principal that has shaped those sorts of studies that say that weight loss is a case of simple math, calories in and calories out. In other words, scientific reductionism guides a lot of study, which then breeds a sort of reductionist world-view among those who in turn seek to further learn about a subject from these studies (the Lorens of the world).
To be able to gain meaningful, quantitative data on a subject, you have to use a method that singles it out and focuses on it. Too much background noise, and you might find yourself with experiments that are inconclusive or are not taken as being useful or having merit.
Doctors work in this fashion. In light of no other “cause” they will often reduce health problems to “you are too fat” because they cannot conduct experiments or obtain quantitative data via a more holistic approach. Because of this, medical research will often draw improper connections between weight and other conditions, insisting that these are cause and effect, when people like me know that in the real world, our lives and the lives of others who have dealt with these issues, it’s more like the way Doctor Who fans view time: life is wibbely wobbly timey wimey. Everything just crashes together and can’t be charged in a linear, cause and effect way.
From what I am getting of nursing, this sort of thing doesn’t matter so much as trying to look at a patient in a holistic way to understand the person not just as a condition, but a person.
So a nurse not only looks at height, weight, blood pressure, etc., things that can be quantified, but also the non-quantifiable aspects of patients, such as their religious beliefs, their family life, social interactions, etc.
In doing so, the focus moves away from trying to form treatment that is numbers focused to forming a treatment plan that will cover all the patient’s needs, both medically, physically, mentally and emotionally.
So, to make a long story short, its the nurses of the world that will probably recognize and find what the above Health at Every Size blog post discusses, which is talking about and studying individual health in a holistic manner.
I really don’t see this type of medical/sociological research being done. And it should be. After all, doctors will insist that weight and depression are a cause and effect link, but if you do not understand the social environment the patient is in, you are somehow left with the idea that fat cells move into the brain and eat up the serotonin or something ridiculous like that.
When it comes to actually talking about health in a REAL way, it has to be holistic, not just formed of medical absolutes or social bias.
That’s the reason why nurses are important, doctors are okay, but scientifically inclined laypeople (like the moderator of I Fucking Love Science) do more harm than good. Because, as a social phenomenon, science is being used to literally defend the personal attack and social attack of individuals and groups. See my last post with the quote from Richard Dawkins.
Science states that they understand things because of qualitative research. But it is so reductive that anything that falls outside of their understanding, or seems to contradict what is most appreciated in their worldview (like science and math for Dawkins) is rendered as being the ignorant folly of backward people who seek to be less than their superior, scientifically-minded neighbors. People like me who say, no, actually, weight loss isn’t all about calories, are told that we are being science deniers, in a way, and blaming others for our weight.
Unfortunately, health as a holistic approach to patient health does insist that weight loss isn’t all about calories. Which is why taking a holistic approach to actual health, not based on numbers, usually works better than the reverse.
But, until you work around nurses, this fact is sort of lost on you. Too many people take their doctor’s words as gospel, or doctors’ words in general… often time to the detriment of their own actual mental or physical health.