“Obesity” is a disease

The fatosphere has been alight this morning with the news that the AMA has officially made “Obesity” a diagnosis (at least the NY Times has a picture of fat kids running. The LA Times can’t seem to do anything beyond put headless fatties next to their story).

Marylin Wann, Ragen Chastain at Dances with Fat, and Atchka at Fierce Freethinking Fatties have already done incredible jobs discussing this issue. I highly recommend reading their takes on it.

I wondered what it the world I could possibly say that would add to what they, and no doubt many others I haven’t read yet, have said. Then I realized, I can talk about how this may affect me as a doctor, and potentially my patients.

As far as how it will affect how I treat patients, well, it won’t. I will still encourage all of my patients, regardless of size, to pursue healthy habits. I will still weigh only when necessary. I will still discourage diets and weight loss for the sake of weight loss. My biggest concern is whether or not, as NDs become more widely seen as Primary Care Physicians (PCPs), as they are here in Oregon, if I will be forced to diagnose “obesity”. Considering that I am not part of the AMA, and I pray that my own national professional organization, the AANP, does not follow suit, it is possible my patients and I will not be faced with that. Regardless, I refuse to diagnose someone as “obese”.

As far as patient advocacy goes, this makes it even more clear to me that there needs to be an intervention at the practitioner level.

A Revolution.

Naturopathic Medicine has long been scoffed at, until something we have been doing to treat various conditions for decades suddenly is “discovered” by the conventional medical establishment. I see “obesity” and the fight for equal medical treatment for fat people in the same way. At some point, everyone, including many naturopaths, will fully realize that not only are diets bad (most people are getting on board with that now), but that lifestyle changes don’t always lead to weight loss and that is not due to a lack of compliance on the part of patients! Becoming an ND has prepared me to “suffer the slings and arrows” of the modern thoughts on “obesity” and health. I embrace the Health at Every Size(R) as an idea ahead of it’s time and as more people (physicians and patients) come to embrace it, I predict that we will see an improvement in health, and maybe even general weight loss (though maybe not). At the least, we will see happier, healthier, more well adjusted people.

I encourage every fat person reading this to have frank discussions with your physician. Fire physicians who do not comply with your health goals (if you can). Find physicians who understand that you are a person, and that your size should not dictate the quality of the treatment that your receive. Don’t let the financial interests of the diet, drug, and surgery industries affect how you are treated. Encourage your doctor to read Health at Every Size by Linda Bacon and start a discussion. Patients will be a big push to get full equal treatment for fat people. Those of us who are already here are working toward it, but we are few and you are many. Plus you have money! Money speaks.

Questions and comments are welcome.

My “obese” cat has the same lifestyle as my thin cat.

Image

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Posted on June 19, 2013, in Uncategorized and tagged , , , , . Bookmark the permalink. 4 Comments.

  1. Glad to see the photo of your kitty. A kitten was dumped on our road three years ago and we went to the shelter to get her a friend (she must have been a litter of one because she was so surprised to see someone her size). The dumped kitten is HUGE, very heavy, something I definitely associate, whatever her genetics, with having been without food. The kitten from the humane society is very lean and slinky. Genetically, she is extremely active (indoor cat); the dumped kitten is far more relaxed (indoor/outdoor cat). Genetics plus, in the case of Olivia, starvation. We can learn so much from observing pets.

  2. Avery Ray Colter

    I have had many cats. They are all outdoor cats and many of them have been fat as well. One of my fat outdoor cats lived to 18 and passed away from old age. Others are past 10. The average lifespan of an outdoor cat is supposedly 5 or 6, and of fat cats who knows?

  3. (Liz, fat people are being maimed and murdered. Cats? Really?) The problem is, where to find the doctor who isn’t potentially deadly. I’ve “fired” plenty over the years, but there’s no such thing as a “No Free Lunch*” organization for doctors who see fat people as human beings. (ASDAH does NOT count — their entire mindset is “fat people all have eating disorders” and “they’re fat because they hate themselves.” In other words, same-old 1970s Susie Orbach BS.) The MDs and NDs need to start having press conferences, and putting decals on their doors, and walking out of AMA meetings if they want us to be able to find them.

    *No Free Lunch is a group of doctors who’ve sworn off drug company swag, free lunches, (hookers), free weekends in Hawaii…

  4. I loved the article, Doc. I want to commend you for swimming upstream, that must be difficult. I have a female cat that looks almost exactly like the cat pictured; same colorings and everything. She is very large; a side effect from having her fixed. She blew up to her current size w/in a month of having the surgery. It doesn’t stop her though, she runs around w/ her thin (male, fixed, now grown) son. We simply love them both.

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