Those of you who are regular readers of this blog are very well aware that I am, shall we say, a person of some girth. According to all possible charts, I am fat, and therefore this culture defines me as unhealthy, despite my perfectly OK cholesterol, my 120/80 blood pressure, and the kind of ridiculously strong genes that make me fortunate to have TWO living parents at the age of 54. These parents, and I hope they don't mind me revealing a bit about them in the name of Making a Point, are hardly paragons of Conventional Wisdom either.

My father is going to be 85 this year. He's overweight, he's sedentary, he doesn't exercise, and while he eats relatively well, he enjoys a good marbled steak with an appetizer of spinach artichoke dip as much as the next person. He has minor health problems, including a chronic illness that does not seem to be progressing and a replacement hip, but other than that, he's fine. He finishes the New York times crossword puzzle every Sunday. He and his wife are in a French club.

My mother (who has been widowed since 2000) is 82. She had lung cancer about 20 years ago. Yes, lung cancer. Do you know what the average 5-year survival rate for lung cancer is? 15%. Mom has made it for 20. She's still smoking. Yes, she has COPD and other health problems, but this is someone who used to smoke nonfiltered Camels, has been smoking since the 1940's, has been overweight much of the time, and is still kicking at 82, living with her feisty little dog. By the way, her husband was slim, active, ate well, did not smoke, and died at 75 of thyroid cancer.

So here I am, with this presumably equally strong constitution. But does any of that matter? Nope. I still get the "lose weight" lecture every time I go to a doctor, with the answer to "What do you suggest" always being "Weight Watchers", notwithstanding the fact that if Weight Watchers were so successful, why is it still in business, and why is my co-worker on her FOURTH ROUND THROUGH THE PROGRAM???

There are bloggers like Kate Harding who try to promote "health at any size", but because in our society we simply cannot take on things like processed foods and corn syrup and plastics which leach crap into our food that promote weight gain, and the stresses of either looking for a job or trying to hang onto one, what we do is blame the entire cost of health care on Teh Fatties.

It should also be noted here that I do not eat donuts. I do not eat Twinkies. I rarely eat cookies anymore. I never eat fast food. I've gone cold turkey from even low-fat ice creams. I don't like chips and Bugles and Chee-tohs and other "snack foods". I work usually 55-80 hours a week. I have been out from work sick five days in the last nine years. So the trolls who want to talk about me sitting on the sofa all day eating baby-flavored donuts can go ply your business somewhere else, because I WILL delete your comments.

I have fought this battle for as long as I can remember. I remember realizing I was fatter than other kids very early on, but my first humiliating memory was of being eight years old, never having gone ice skating before, and going to an ice skating birthday party for a "friend", where I ended up being shlepped around the rink by the birthday girl's older sisters, who talked THE ENTIRE TIME about how if I wasn't so fat they wouldn't have to do this. I wasn't all that fat, either. I look at my old high school yearbook now, the one from my junior year where I'm in the front of the homeroom picture, wearing a zebra-striped jumper I'd made myself that barely covered my ass, with black tights, and wondering how on earth that girl ever thought she was fat.

The only time in my life that doctors haven't given me the Lose Weight lecture was in 1983, when I went on Cambridge Diet -- a 300 calorie a day, allegedly "nutritionally complete" liquid diet that was guaranteed to make the weight just POUR off. I weighed 118 when I started. Sixteen weeks later, I weighed 105 -- a massive weight loss of thirteen pounds in four months. During that time, I was going to a health club five nights a week, where I took an hour aerobics class, followed by a half hour of weights.

Thirteen pounds in sixteen weeks. Even with all that. But I was at last a size six. For about five minutes. I had no tits, but I was a size six.

The minute I started eating any solid food at all, the weight started piling back on. You see, I met Mr. Brilliant during that time. And when you date, you go out for dinner a lot. And I would sit in restaurants pushing my food around the plate and going on crying jags that I didn't understand. When I did eat, I'd go home that night, but on my Jane Fonda Workout album and do an hour of aerobics in my apartment before going to sleep. Later on I knew what the crying jags were about. I WAS HUNGRY, DAMMIT. Finally, one day at the Feast of San Gennaro, Mr. B had had quite enough of this. It was either stop this madness with food or be crazy without him.

As I go further into middle age, I'm making small changes to how I deal with food and recognize things that I could do better. This year I've given up diet soda under the assumption that when you are used to having a sweet taste in your mouth all the time, it just makes you crave sugar. I realized that sometimes I eat too fast just because I want to get to the seconds, when I'm really satisfied with the firsts. As I mentioned on our sister blog, Disciples of Joe, we're trying to eat less meat.

I know from past experience that defining oneself as "good" or "bad" as a person based on what one eats is a sure path to sitting down with a half-gallon of Edy's French Silk and a spoon...even if one doesn't even WANT a half-gallon of Edy's French Silk. For many of us, the minute the word "diet" is used, we want cheesecake, even if we don't LIKE cheesecake. "Breaking the diet" is, in my opinion, a sane reaction to an insane situation, that insane situation being substituting boxes of frozen crap put out by food conglomerates for actual food that satisfies and nourishes. Small, incremental changes are much easier to make, and far more productive in the long run.

How many people, particularly women, do YOU know who are heating up tiny boxes of frozen crap for lunch every day because they gained weight over the holidays? Come back in a month and tell me how many STILL are. Then check and see how many bags of M&Ms they have squirrelled away in their desk drawers.

A few years ago, I went to the gynecologist I'd been seeing for 20 years. I always liked her because we talked about movies and she never gave me shit about my weight. She was pretty, and maybe ten years younger than I was, so she was just starting to get to that thing that happens around age 45 when you start noticing changes in your face and your body on a daily basis. That year she was going to her high school reunion, and had lost 40 pounds on "The Accubead diet." On this one, you go to this psychologist who gives you these accupressure beads to put behind your ears. Then you alternate days: On Day 1 you consume 2-1/2 cups of whole milk and nothing else. On Day 2 you consume a pound of vegetables and nothing else. Repeat and repeat and repeat. When you get hungry, you press the beads and it tricks your hypothalamus into thinking you aren't hungry. 20 ounces of full-fat milk is about 500 calories. That isn't all that much different from the Cambridge Diet I was on. So, thanks but no thanks. So after 20 years I had to find another gynecologist, because mine had gone through a midlife crisis and wanted to look good for her reunion.

This is madness.

Weight is more than just calories in, calories out. In 1983, I was expending far more calories than the 300 a day I was taking in with three 100-calorie water shakes every day, and I still lost less than a pound a week. Study after study debunks calories in, calories out, and the answer researchers always give is not that we are all different, but "If you metabolize slowly, you just have to work harder at it than other people." It can't possibly be that our bodies are doing what our own, unique, particular bodies do. No, we just have to starve ourselves and work out five hours a day, that's all.

Now, all this said, there ARE things I can do to be healthier. Now that I'm older, I do feel the effects of weight more often. But I think the weight I'd need to lose in order to not feel these effects is perhaps 20 pounds, not the fifty that the charts would have you believe. There are ways I can eat in a more healthy way, like making barbecue brisket a treat instead of a habit. They are putting in a gym at work, so I can move this body during the day -- something that's hard to do outside of work hours when you leave the house at 6 or 7 AM every day and most nights don't get home till 6:30 PM and you need at least 6-1/2 hours sleep.

But thanks to the Senate, health care reform won't care about these changes, and it won't care about your health. It's only going to care about broad-based numbers in a one-size-fits all; even if you're 4'10" tall and couldn't get down to 95 pounds even when you were 25:

A little-discussed provision of the Senate bill allows insurers to expand so-called wellness programs that allow insurers to penalize subscribers by hundreds—and even thousands—of dollars for not meeting certain "wellness targets," such as a particular cholesterol number, blood sugar measurement or body-weight target.

Remember all those Democrats pleading plaintively, in the face of Republican accusations that the GOP had been cut out of the health care debate, that actually they included many Republican ideas in their health care bills? Well, this is one of them. One of the pro-business innovations of the Bush administration was to introduce into health insurance regulations a provision allowing employers to offer loosely defined "wellness" programs that carry incentives for employees meeting certain standards of premium reductions of as much as 20 percent. Sounds like a pretty good deal, right? Sure, until you realize that there's no baseline for the original premium, meaning that, in reality, people who don't meet the standards are really carrying the burden of others' discounts and then some—paying as much as 20 percent more for a policy in which a family member's failure to meet a wellness target forces up the entire premium for that family's policy.

If you think that's a raw deal, consider the Senate health care bill provision introduced by Sen. John Ensign, the disgraced Republican of Nevada. Now that percentage of discount or penalty, depending on which end one finds oneself, can amount to a differential in one's premium to 30 percent, and eventually to 50 percent.

So what is "wellness", anyway? Is an anorexic with a BMI of 18 "well"? What about people with congenital high cholesterol? What happens to the livers of people who start taking Lipitor when they're ten? When will people not have to work 80-hour weeks to show how valuable they are to the company so they HAVE the time, and the energy, to take a walk, play tennis, do yoga, or other forms of exercise that don't feel like a chore?

Wellness is a laudable goal. We all want to be well, and it's to society's benefit that we be well (except to the extent that we cost more when we live longer). But wellness comes in all sizes and habits. And because the research community has never wanted to touch this fact, we are left with legislators who have plenty of time to use the Congressional gym telling the rest of us we just have to eat less and work out more. In 1983, I ate about as little as was possible, and worked out every day. I had no life, I was miserably unhappy, but I was thin. Perhaps a nation of misery is what they really want.

Labels: health care, just another outrage, weight