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FAT MEDICAL ADVOCACY | The Real Causes of the Obesity Epidemic | My Three Hundred and Fifty Pound Weight Gain | The Failure of Size Acceptance | Round Responses | Write The Largest of All!
FAT MEDICAL ADVOCACY
The Largest of All

Fat Medical Advocacy

This page has information on getting the medical care you need, diseases that affect weight and much much more.
I have always felt that those struggling with severe obesity needed a place to turn to support and the sharing of vital information. Please if you have a link or other topic ideas to cover email them.


Challenges facing Fat people in the medical arena. Many that need to be changed:

1. Scales that rarely go above 350 pounds, making it almost impossible to monitor weights over that figure; electronic scales that only go up to 400 pounds, forcing the supersized person to use other means, like bulk mail scales, in watching their weight.

2. Neglect in seeing other disorders that can cause weight problems; not warning patients about weight changes from medications; not testing those suffering weight gains from thyroid problems, ignoring obvious symptoms, pituitary problems and other glandular diseases. Doctors are told so often that glandular diseases are the exception rather than the rule, many suffering people get lost in the shuffle.

3. No insurance coverage for most weight-loss programs, even those mandated for severe obesity and health problems related to it ; fat people being denied insurance to begin with, making care more expensive in the long run as they cannot afford preventative care.

4. Lack of equipment for overweight peoples needs; wheelchairs that are too small, with no large ones available, or incapable of holding over 350 pounds; tight blood-pressure cuffs, which can give false readings; beds and tables too high and narrow for a fat person to sit on comfortably; surgical tables that cannot support a fat persons weight; enclosed MRI units that cannot fit people over 350lbs.

The list goes on and on.. There are many changes that are needed in the medical world for the good care of fat people. Most medical professionals are well-meaning . Education usually makes changes. Talk honestly to your care provider about any of these issues. Most will try to meet you half way.



AS A FAT PERSON, SELF-ADVOCACY IS ESSENTIAL

1. Always ask for what you need. Tell a nurse or doctor if you need a large cuff. Refuse to use one that hurts your arm or cuts off your circulation; if your arm goes limp and numb..take it off! If you need a wheelchair to be transported in the hospital, call ahead for one. Often most hospitals have at least one wheel chair to accommodate a large person (although clinics may be more problematic).

2. Find a main doctor that treats you as a whole person and looks past your weight. This is invaluable. You may go through even as many as three to five doctors but finding the right one will serve your needs the best. You want someone with compassion and who cares. This may save your life in the long run. My own doctor is excellent. A good doctor is a very important person to have in your life.

3. Remember, you know your body best. Dont let a doctor blame your weight for a variety of symptoms, from loss of periods to unusual blood test results. Investigate things further. Dont blame weird symptoms like hair loss, skin breakouts or even weight gain on stress!

4. Expect the best from people and be polite. Most medical professionals are usually very caring individuals. Most fat people will be treated right. But if someone is rude to you because of your weight or makes faces as they take your temperature, dont let it go. Refuse ill treatment. Refuse to let someone make you feel uncomfortable.

5. Ask questions. Always check the dosage of everything you are handed. If you are too sick to ask, family members should check prescriptions as much as they are physically able. Ask about side effects of medications.
Reading ones medical file is invaluable to assess the real opinion of doctors. You have every right to ask for your medical file and/or obtain a copy of it. This is true of medical and psychological files.

PS: Remember, doctors do not know everything. The human body has shown extremes in every compartment of function.

Obesity Research--links to obesity journals and information

The Physiology of Morbid Obesity

Sleep and Obesity--article on effect of sleep disorders on weight.

Barbaras Obesity News and Research

www.obesityhelp.com---weight loss surgery site--contains articles concerning obesity

Nutritional and Metabolic Diseases--good section on obesity

PCOS Support

Cushings Support site--full of information on many endocrine diseases

Lymphedema ezine

Life's Forgotten Angels

Thyroid Disease Information Source

Sleep apnea and other Sleep disorders

WEIGHT REALITIES: THE FAILURE OF TRADITIONAL METHODS

Well, I'm sorry to shatter your dream but it is impossible, biologically, to stay on a weight loss diet. Unless you go totally crazy -- like women with anorexia nervosa, because they get so cut off bodily sensations, that they do not eat at all or eat very little...But if you mange to stay sane at all, you will feel the furious message from the body to please nourish it. It will pull out all the tricks it can get you to take in some energy, It will make you think of nothing but food.

The Goddess is Fat, Shadow on A Tightrope, Kelly

Overweight people, as medical study after study has proven, are fighting biological urges and setpoints -- not willpower and gluttony. Obesity is a chronic disease that is difficult to control. While some may lose weight by dieting, consciously overriding ones homeostatic control mechanism requires attention and vigilance which takes time and energy away from other duties. As soon as that vigilance is relaxed, the natural control mechanism will take over. (Dr. Robert Yaes, in a letter to JAMA.)

Weight is more a matter of this homeostatic mechanism than a voluntary choice; through several studies it has been learned that setpoints are dictated by genetics. There are 30-40 neurotransmitters determined by genes that influence how much one eats (and hunger, too). Think of the times you have had the flu.your appetite is naturally lowered by the body to fight the illness. Appetite is a matter of brain chemistry, not willpower and moral fortitude.


Society needs to stop the blame game, because its methods are not working. New improved methods and more money for research needs to go into methods that are not harmful to fat people. Environmental things need changed too. Finding a healthy meal while on the road should not be harder then finding a needle in a haystack.

Often it has been proven that people who grow up fat have a harder time losing weight, rather than those who start thin and gain weight due to an outside force, such as pregnancy or a traumatic life event. People are fat due to a genetically inherited control mechanism, not a lazy, slothful or weak will. Prejudice helps no one. Many fat bigots use the health hammer over the head of fat people. Remember self-love is more conducive to healing not blame and hatred. Take responsibility for what you can --- most super fat people cannot afford to make a piece of cake a daily habit, for example, and past that point realize obesity is not a disease of character.

Dr. David Wiegle (University School of Medicine, Seattle) describes four common MISCONCEPTIONS about obesity:
1. Body Weight is not a physiological regulated variable, but is set by acquired eating habits and conscious/unconscious desires.
2. An individual can set his or her body weight to any desired level without adverse effects on their health.
3. Everyone weighing more than the numbers set in certain life insurance tables is at increased risk of mortality.
4. Body fat distribution is not an important health consideration.

These are the WRONG beliefs that foster discrimination and ruin the health of fat people. First, we now know that weight is a matter of brain chemistry. Leptin, a chemical in the brain, controls feelings of satiety, not stubborn adherence to a diet.

Body weight has been proven to be determined by a multitude of factors that far surpass the traditional view of energy intake/energy expenditure. Obesity results as a imbalance between these two, but these factors are determined much more than by eating. The brain controls many multitudes of these factors, from neurotransmitters that determine appetite levels, to endrocine signaling -- such as through the pituitary gland, the master gland that determines metabolic levels.

Problems can occur anywhere in this system; diseases that affect these glands affect ones weight. Simply put, there are fat people who do overeat and gain weight by an insurmountable appetite, but even science would fathom that some people's brain chemistry can determine such a huge appetite. Other fat people eat normal amounts of food only to gain huge weights quickly; some notice a change in their weight control due to a prescription drug, or pregnancy, for instance. Others have their movement restricted by arthritis, asthma, joint diseases. A selection struggle with satiety disorders that lead to overeating. There are many factors behind obesity.

As Xlaud Bouchard (Laval University, Quebec City, Canada) explains:
The pathways regulating weight form a series of redundant regulatory loops, so if one is weak or attenuated, others can take over. Even when one gene is knocked out, other pathways can compensate. It is this redundancy that helps the organism regulate caloric storage but the same redundancy makes it hard to get a hand le on how to prevent or treat obesity.

These differences have been made apparent in many studies. It's possible for two people of the same height and age to maintain the same weight -- even if one eats twice what the other does. It's also possible for a person to eat less than a person of the same activity level but weigh more. (Rose & Williams: 1961).

Traditional methods of weight loss have proven ineffective; after all, Jenny Craig was forced to put on the bottom of their advertisements, "results not typical." Weight is lost and regained over and over, yet much of Jenny Craigs business centers on repeaters! Other diet centers share in this experience. The health problems of yo-yo dieting are proven.

Everyone has seen a skinny person who can shovel it down and not gain an ounce. Why is this is not questioned when the opposite happens to a fat person? People waste away due to hyperthyroidism (an overactive thyroid), as opposed to hypothyroidism, an underactive thyroid which causes weight gain. A woman on the Internet admitted she weighed only 125 pounds and was six feet tall at the time of her diagnosis. It is a definite matter of more than energy input equals energy expenditure. Don't accept these simplistic explanations.

WHAT DOES ALL THIS ADD UP TO?
1.You deserve the same medical treatment as anyone else.
2.Confront negative and false attitudes towards your weight.
3.Refuse to play the blame and shame game in reference to your weight.
4.Trust yourself and be your own medical advocate.
5.Educate others to your own reality as an overweight individual.
6. Be as healthy as you can be no matter what you weigh.
7. Take responsiblity for what you can. Many fat people have to accept that they may never be model thin, but they may be able to maintain a lesser degree of fat for added health.

What is needed for weight treatment:

1.Better food . Processed food is destroying the health of all people. Thin and fat. Unnecessary sugar and fat is being added to many foods making healthy eating far more of a challenge. This also works on the body to create further unnecessary cravings. The less processed a food is the fuller you will feel. Fat people need to get the most nutrients in the least calories. This is done easier by eating wholesome foods like legumes, vegetables and grains rather than the American diet of French Fries, hamburgers and Fritos.

Nutritional Knowhow. Cut as many processed foods out of your diet as possible. Read for added sugars, corn syrup and palm oils. Avoid any unnatural processed fats such as margarine and avoid juice with sugars added. Processed foods lead to less satisfaction. A McDonald's meal lasts a much shorter time than a baked potato and a broiled chicken sandwich. Processed foods make it harder to lose weight.

One major problem with some diets is that the calories are too low and the body still needs nutrition. Many fat people simply have lower metabolisms. People need to find what calories they can stick to, i.e.: what won't lead to excessive food cravings -- too low and what will keep them from gaining weight. Keeping diet journals can help an individual find their own levels of comfort and health.

People in general and Fat people need more exercise opportunities. This is changing with some new gyms for women only and the full figured cropping up. Slow and steady movements are important for everyone. If you are bed ridden even raising your arms up and down will do some good. If you cannot walk do some chair exercise. Fat hatred and shame has also affected exercise for fat people however many people are working on changing that. More understanding too is needed regarding the physical limitations on superfat bodies.

Weight Loss treatments that work by shaming and blaming are ruining the health of many and leading to higher rates in obesity. Diets do not work. only total change does. When one starves themselves, they cannot maintain this forever, when even average eating is returned to, the inevitable weight gain begins. Diets under a certain amount of calories are doomed to failure.

Lifestyle plans are needed that are realistic. Not for saints or matyrs but for real people. Slow weight loss is a path many take. One needs to find a lifestyle that works for them and is the most healthy. The fact is some fat people will be fat the rest of their life. The challenge is finding what lower level of fatness is maintainable. The focus should be on health not appearance. Lifestyle plans can be limited in their influence -- many fat people still continue to struggle with a certain degree of obesity, especially in complicated metabolic or genetic situations. However, doing what one can do for their health is always important.

Very Low Calorie Diets
These can have an overall effect on metabolism in that they lower it. This is why you hear of very fat people regaining weight after low calorie diets. Also these are used on fattest of us quite often. Walter Hudson and Michael Hebranko -- a 1,000-pound poster child for Richard Simmons -- lost tremendous amounts of weight, only to regain it just as quickly. The logic is skewed: how can one be expected to eat 800 calories over a lifetime, and maintain this semi-starvation state accordingly? In reading an informal study of 30 cases of people over 900 pounds, not one lost weight on such a diet that lasted or led to an improved lifespan. Fat people aren't failing on these diets due to bad willpower or gluttony; many physiological processes are behind the failure of these diets.

Liquid Protein Diets and Carbohydrate restricting programs basically rely on proteins and the exclusion of carbohydrates. I personally feel that if taken to the extreme these can be unhealthy. If too low in calories they are sure too fail. For carbohydrate sensitive individuals and insulin resistance persons, lowering of carbohydrates in the diet can be helpful in weight maintenance.

Some people will choose to stay large and thats ok. As long as one is healthy, this is what should matter. However, self-honesty is needed and a moderation about what one's body can tolerate.

Weight loss surgery is seen as an answer for severe obesity by some. Many ex-severely fat people have discussed it as being a life-saver. I am still examining this issue but more have gained a more moderate view of WLS. It's up to an individual to weigh the risks of WLS against the effects of super morbid obesity on their body. Knowing the severe effects of obesity personally, I understand why people may make this choice even with some of my ongoing concerns. I will continue more research and include some links on here.

I don't have all the answers; who does? But I think discussing ideas can only lead to increased support for all concerned.

The above is written by a layperson and is not to be taken as medical advice.

Unknow to many people including fat people themselves, there are many conditions that can influence weight negatively--and which are a causation of weight. .

Hypothyroidism
Cushings or Pseudo-Cushings
PCOS (Stein Levanthl Syndrome)
Syndrome X
Diabetes
Hypothalymic lesions
untreated Sleep apnea and Central Sleep apnea
Satiety disorders--these are related to what is referred to as eating disorders which used to be seen as pyschologically caused but in reality are related to physical bodily processes.


Other conditions that can influence weight occur in children, such as Prader-Willi

Co-morbidites of weight and which many superfat people struggle with include:

High Blood Pressure
Lymphedema--water retention and swelling of limbs
Sleep apnea--this goes both ways
Diabetes
Skin disorders
Shortness of Breathe
Arthritis in the knees.
Congestive heart failure.

There are many other illnesses heavy people especially have higher risks of including some cancers and other heart troubles. It is important that those who are heavy do not let shame keep them out of the doctors office. Find a doctor who will treat you with compassion. They are out there. Take care of yourself the best you can.