Obesity

Long time, no see

2:11 am on Sunday, July 17, 2022

Insomnia has struck again. So, I decided I need to start blogging again. Not for anyone other than myself or any reason other than I miss writing…even though I don’t really know what to write about anymore. I just looked and realized it’s been more than a year since I wrote anything here. I’ve written posts on FB and IG. Many of those have been essay length. But, nothing like blogging.

I miss the blogging community I used to be part of. I miss that sense of connectedness through language. So, here I am, wanting to rebuild my writing self. Who knows, maybe I’ll build something new inside of me.

For anyone who followed me in the past, I’ll try to give a quick synopsis. For any who are reading me for the first time, I’ll introduce myself.

July 16, 2022

Hi, I’m Lillian.

I’m a 53 year old mother of three and grandmother of four. My youngest child is 13 and experiences the world through the Autism Spectrum. My two oldest children are 35 and 29. The 29 year old and their 29 year old partner have four children: 8, 7, 4, & 2…their family lives with me. So, when my teenager is home, there are eight humans and one canine…in a two bedroom, one bath apartment. Yeah. You read all of that right.

After not being employed since mid-2012, primarily due to mental health reasons and the special needs of my youngest, I was finally able to rejoin the workforce in April of 2020. I started as a Residential Counselor in Supported Housing for adults experiencing mental health challenges. A year later, I transitioned into my current role as an Adult Mental Health Peer Wellness Specialist. Basically I get to use my lived experience of coping with mental health challenges (and navigating all the systems which impact a person living with those challenges) to walk alongside others going through similar challenges.

Who knew my trauma history and mental illness could be a positive force in the world? I certainly didn’t for most of my life. Now, here I am, doing the work my life has equipped me for. I’m turning the excrement of my life into fertilizer in the lives of others. That gives me a sense of purpose…something I lacked for a very long time.

All I could see were my limitations and defects.

It’s Disability Pride Month. There isn’t a fully official flag…yet. I did some research on what the colors represent and put together a flag which represents what I live with on a daily basis.
Black = Sleep issues = Sleep Apnea
Purple = Chronic/Acute Pain = Fibromyalgia & Neuropathy
Red = Heart issues = High Blood Pressure
Blue = Thyroid issues = Hypothyroidism
Yellow = Obesity
Green = Mental Illness = Bipolar 2 Disorder, Depression, cPTSD, & Binge Eating Disorder
Black = Sleep issues = Chronic Insomnia

My Disability Flag

Currently there are two main things I’m struggling with out of this laundry list of ailments: Diabetes, type 2 & Bipolar Disorder, also type 2.

Back in February, I found out that my A1C was 11 and my non-fasting blood glucose level was almost 500. If you don’t know what these numbers mean, that’s actually great for you. It means it’s likely you don’t have diabetes concerns. On the other hand, if you research it and check out the symptoms list, you may discover you need to learn more about it. Anyway, basically, I should have been hospitalized…and my doctor of that time actually requested I go to the ER to get checked out, three days after those tests were done.

In March, I started a rigorous (and expensive!) nutrition program. It worked. I lost seven pounds the first week. By week three I had to reduce my insulin intake by 15 units. On April 1st I rejoined WW (Weight Watchers). I was on a roll and doing really well with my activity, my eating, my thinking, and my creativity. I had more energy. I gained more confidence. I was feeling really proud of myself. Then my bipolar brain started going haywire.

All those feel good things and lifestyle changes, along with seasonal changes, impacted my neurochemistry and sent me into manic mode…but I didn’t recognize it until several weeks had passed and I was completely off the rails with risky, out of control behavior. I couldn’t face the truth until I realized how much I was risking: my health, my mental health recovery, my relationships, and my future. It was very demoralizing once I faced the truth.

I talked to both of my therapists, my prescriber, and my newest doctor. Adjustments were made and it took another few weeks to come down. Then, I spiraled down. I stopped moving. I reverted to old patterns and the binge eating began. I quit the nutrition program…I couldn’t afford it and the “health coach” I had was really aggravating me. Then, I stopped attending the WW virtual workshops and skipped the in person studio workshop, after two weeks of weight gain. Additionally, financial changes out of my control started happening with my employer and a creditor. So, I realized I wouldn’t be able to continue with WW, once my initial membership commitment expires in September.

I very nearly gave up.

Friday night I logged into my first workshop in nearly two weeks. I showed up at the studio yesterday and weighed in. I had gained almost eight and a half pounds in two weeks. My heart plummeted and I felt nauseated. It was very disheartening. At the same time, it was motivating. I went home and decided I was going to something to make me feel good about myself and I did my makeup, which I hardly ever do. I used color, which I never do. I used green to represent the Bipolar I’ve been battling.

I’m still committed to taking the bad and using it to do good.

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An open letter from a fat woman

Dear Everyone (including fellow fat people),

I realized something yesterday. I don’t enjoy being asked if I’ve lost weight or gotten smaller. This question is usually asked by those who are slender, generally healthy-looking, and physically fit. However, others who are also overweight will ask the same question. Often this question is accompanied by facial expressions and asked in a tone of voice which indicate the person is issuing a compliment and an encouragement. For those who are aware of the mental/emotional health issues I deal with, this question is followed up with, “You look happy, like you’re doing good/better.” It occurred to me that I feel neither encouraged or complimented most of the time. In fact, part of me feels frustrated and defeated, less than.

I had two people who I know love me and care about my well-being ask me at two different times yesterday if I had lost weight. Last weekend a third person asked the same and two weekends ago, someone asked me if I had gotten smaller. Four different people over a two-week period of time, all of whom hadn’t seen me in a month or more, asked me if I had lost weight. Each time, I felt obligated to say, “Thank you.” However, because I’m almost compulsively honest, I followed that up with, “No, I think I got smaller but then got bigger again,” because I know how the mental health disorders I experience have manifested in the past three months, as stressors in my life have multiplied, almost exponentially, and that I’ve been abusing myself with food. I know how my body feels, how clothing feels on my body, and how body has changed shape again in response to the binge eating and unhealthy food choices I’ve been struggling with.

Why not just accept the compliment and keep the rest to myself? It’s dishonest. I feel like I need to be truthful with myself and with others. If I were to say, “Thank you,” and move on, then, part of me would believe the lie that I’m doing better than I am and that the issues I’m having around food aren’t “that serious” or of concern. In the world of addiction and recovery, that’s part of the slippery slope of denial and it’s dangerous on many levels: physically, mentally, and emotionally.

For me, being fat is an outward sign of my food addiction and binge eating disorder. It is a sign that the depression aspect of the Bipolar II Disorder and the anxiety part of the PTSD are in more control than my rational self and spiritual being. If I accept the compliment and move on, then, I experience a sense of shame about these things, because I’m keeping them hidden from people I care about and who I know care about me. They need to know that I’m not okay. I’m not doing better, and that I still need them to be aware that I need them to see the truth that I’m not well and need their continued awareness that I’m still at risk.

This compliment is also an unconscious form of fat-shaming. It sends the message that I’m more acceptable if my physical appearance fits into an idealized shape more like theirs. These same people wouldn’t express their concern for my mental or physical health by asking me outright, “Have you gained weight. Are you doing okay? Is there something going on?” That question doesn’t get asked because it’s considered rude to comment on someone’s obvious weight gain. Why is it rude? It’s rude because gaining weight is often accompanied by a sense of shame, a sense of failure, and we are conditioned to avoid pointing out people’s shameful things in public ways . . . unless we’re doing an intervention, we’re assholes, or we’re talking about celebrities and other public figures.

Complimenting a fat person for losing weight sends the message that you believe they are less acceptable when they look more fat and that looking less fat makes them more acceptable. It reinforces the belief that no one wants to see a fat body, therefore, as long as I’m fat, no one wants to see me, because they won’t see me, they’ll just see my fatness.

In some ways, being fat and trying to lose weight is like being poor and trying to get rich. Society sends the message that being fat isn’t acceptable. You can exercise it away, you can eat it away, you can choose whether to be fat or to be thin. To some degree, those are true statements. Society sends the message that being poor isn’t acceptable. Get a job. Get an education. Get a career. Save money. Set a budget and stick to it. These things are also true, in certain ways. Yet, none of these things acknowledge very real barriers and systemic forces which exist and make those things more than challenging for people experiencing obesity or poverty.

Root causes of obesity go beyond eating too much of the wrong food and being physically inactive. I can’t tell you how many thin people I know who eat junk food all day long and live primarily sedentary lives. As a matter of fact, I lived with one for 18 years. There are genetics, mental health issues, ingrained generational patterns of lifestyle, physical health conditions, financial capacity, and life obligations which all factor into whether a person is fat or not.

Root causes of poverty are equally complex. I know people who work multiple jobs, don’t spend their money unwisely, shop with thrift, and work to save their pennies, but who remain poor. It takes money to make money. In order for someone to get an education that, MIGHT, lead to a good paying position, on a high earning career track, there has to be enough money to pay for the right education, often at the “right” educational institution. There has to be enough money to keep the bills and basic necessities, such as housing and food, stable. There has to be enough money to pay for the supplemental educational tools. In order to save money, the student repayment debt, as well as the costs of housing, food, transportation, clothing, and health insurance cannot meet or exceed net earned income. There has to be enough time and peace to allow for homework to be focused on and done well.

The correlation between poverty and obesity is also a real thing. If you experience poverty, then your ability to afford the healthiest foods is compromised. Your access to those foods is compromised if you are reliant on public transportation because you can’t afford a vehicle. The time you have available to prepare home cooked meals is limited. If you live in poverty, you typically are either living with a lot of other people in a small space or may not have a home at all, so buying in bulk and storing food is not possible. If you are a parent of young children, living in poverty, you can’t afford to pay for childcare while you go exercise. Being able to afford a gym membership is out of the question and the money required in order to pay for supportive footwear for walking, jogging, or running is needed to pay a bill or buy school clothes for the kids.

I experience poverty, as well as mental and physical health issues which are all interconnected with the fact that I am morbidly obese. I’m working on all of those things and I have a lot of things going on in my life which demand my time and attention. I don’t enjoy being fat. It’s physically, mentally, and emotionally painful. I don’t enjoy being poor. It’s also a painful experience. I am doing what I can, as I can, to work on both of those things, but, I don’t know that I will ever be able to do enough to change either of those conditions in order to be acceptable enough.

So, please remember, complimenting someone who may look like they have lost weight, but you may not know if they’ve been working to do so, is not necessarily a compliment. Even then, compliment something other than their loss of fatness. Compliment their clothes. Acknowledge that they are exuding a sense of self-satisfaction and happiness. Or just tell them how happy you are to see them and spend time with them, without commenting on their appearance at all.

Sincerely,
A Fat Woman

Fat and Poor? Time to get to work

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A friend of mine shared this article regarding the AMA’s decision to declare and classify obesity as a disease. You can read it here. The article mentioned two things that struck me. The first was that the pharmaceutical companies would be pleased because of the associated increase in production and sales of weight loss drugs, because reclassification as a disease means insurance companies will likely have to start covering weight-loss medications. Then there was this:

Some hope that designating obesity as a disease will remove the stigma associated with it, and obese people will no longer be blamed for their condition. Yet already it is being called the “fork to mouth” disease, and the disease categorization may reinforce blame by raising the stakes. If obesity is a disease, parents of fat children may not merely be silently judged as bad parents but also accused of neglect and child endangerment.

For those families living in poverty – a significant number of them headed by women – some of the same root causes and correlations of poverty are the same as those for obesity.

According to Donna Beegle, PhD:

Food stamp values amount to $3 per person a day today, she said. “People say there’s no hunger in America, there’s obesity,” she said. “Well, that shows our ignorance about what you can buy for $3 a day. You buy what fills you up. You can’t buy health food.”

This statement is supported by this 2004 article from The American Journal of Clinical Nutrition: Poverty and obesity: the role of energy density and energy costs1,2

Among women, higher obesity rates tend to be associated with low incomes and low education levels . . . Although obesity rates have continued to increase steadily in both sexes, at all ages, in all races, and at all educational levels (26), the highest rates occur among the most disadvantaged groups.

Food insecurity and obesity also appear to be linked . . . food insecurity was defined as “limited or uncertain availability of nutritionally acceptable or safe foods . . . Households with children were twice as likely to report food insecurity (35). Among low-income families, food insufficiency was associated with single-parent families, not having health insurance, and having a family head with < 12 y of education.

I am a medically obese woman, living in poverty, with untreated physical and mental health conditions. I do have some college education, however, I haven’t yet been able to obtain a degree and have massive amounts of educational debt.

I live in a subsidized housing property with a tiny kitchen, little storage, and less food preparation space. I have recipes and knowledge about how to plan menus and prepare healthy meals. I don’t have some of the basic equipment and tools to prepare homemade meals. Some of the equipment I do have is cheaply made and damaged to the point it probably shouldn’t be used. I can’t afford to purchase things like mixing bowls, casserole dishes, food processors, and juicers. Because of the fatigue, sciatic/back pain, and neuropathy in my hands the time and effort required to prepare a healthy meal means, I am not able to do the prep and clean-up and have the capacity – mentally, emotionally, and physically to constructively interact with and keep up with my four year old. My story is not unique.

I make the healthiest choices I can afford to – financially and in other ways. I am making changes in my activities and working hard to prioritize my values over both my physical and emotional feelings. There is a lot I had given up on in terms of myself and the goals and dreams I once had. I am fighting hard to forge a new path and create a new future for myself and for my family within the context of illness and poverty.

I’m overcoming overwhelming feelings and attitudes of guilt and shame, which have been informed and exacerbated by prejudices, myths, and stigmas associated with things like mental illness, obesity, race, gender, and poverty.

What are some of your beliefs and assumptions about poverty and obesity? How do these things affect how you look at and think about the people in your community based on their physical attributes and external behaviors? Do you know where those assumptions, beliefs, and attitudes come from and if they are based in actual reality or based on sound-bites and extreme examples?

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