"Only dull people are brilliant at breakfast"
-Oscar Wilde
Brilliant at Breakfast title banner "The liberal soul shall be made fat, and he that watereth, shall be watered also himself."
-- Proverbs 11:25
"...you have a choice: be a fighting liberal or sit quietly. I know what I am, what are you?" -- Steve Gilliard, 1964 - 2007

"For straight up monster-stomping goodness, nothing makes smoke shoot out my ears like Brilliant@Breakfast" -- Tata

"...the best bleacher bum since Pete Axthelm" -- Randy K.

"I came here to chew bubblegum and kick ass. And I'm all out of bubblegum." -- "Rowdy" Roddy Piper (1954-2015), They Live
Tuesday, January 12, 2010

Be a size 0 or be prepared to pay the price
Posted by Jill | 6:34 AM
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.

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Anonymous mandt said...
"Perhaps a nation of misery is what they really want." Exactly so.

Blogger jurassicpork said...
According to all possible charts, I am fat

No you're not. As people in your folks' generation would've said, You're a lady of substance.

Slim ain't all what it's cracked up to be. Remember, Jim Fixx died while jogging. But if you want to do cardio and go on a diet, if you honestly think this will lengthen your life span, then go for it.

Dieting is nothing more than disordered thinking. There isn't one trick that anorexics use that isn't promoted on diet websites and magazines.

A dear loved one of mine is currently in the 'refeeding' process from Anorexia. She eats between 3,000 and 3,500 calories a day, and is only gaining about a pound a week. Her metabolism is in overdrive, repairing the damage done to her organs through starvation.

Another loved one of mine went through anorexia a few years ago. She was hospitalized at 127 lbs, because where that may not be unhealthfully thin for some women who are 5'6" or 5'7", it was too thin for her, and her heart rate slowed dangerously. She almost died of heart failure.

I was reading about one of the 'biggest losers' the other day. She eats about 1200 calories a day, and exercised for 4 HOURS a day, and is maintaining her weight.

Every body, every metabolism, is far different.

Oh, and another dear loved one of mine has high blood pressure and pre-diabetes, even though he is within the doctor's healthy weight range, doesn't smoke, eats very well, no junk, no candy, and exercises 3 or 4 days a week. It's heredity.

The idea that the senate is going to punish all of these people, going to judge them for their bodies, is going to increase eating disorders. Dieting, starving, bulimia, all of it. If dieting worked, no one would need to do it. End of story.

Blogger BadTux said...
There has been way more research on this question than necessary to answer the question. The question, BTW, is:

"How much overall do we save in health costs if we eliminate obesity and smoking?"

The answer, surprisingly, is... nothing. In fact, we spend *more* on healthcare if we eliminate obesity and smoking, because while smokers use more healthcare per year, their life averages ten years shorter than non-smokers' lives -- and dead people don't use any healthcare at all. There's been actual studies on this, that added up the lifetime health costs for both smokers and non-smokers, and *none* of them showed that smokers used more healthcare than non-smokers over the course of a lifetime.

In other words, look elsewhere for why proposals to charge more money to smokers and obese people get such traction. Like, greed, duh? It's a worthwhile goal to do something about smoking and obesity, but it's a good idea because you feel better and live longer, not because of money.

- Badtux the Healthcare Penguin

Anonymous Comrade PhysioProf said...
Powerful post, Jill!

Blogger Thursday's Child said...
There's been something a storm of controversy lately in the fashion biz around V Magazine's 'size' issue which should hit newsstands tomorrow and has been sneak previewed over the last few weeks at http://models.com.

Every commenter who commented about women 'not keeping themselves up', 'not taking care of themselves' and other remarks of that ilk, should come here and read this post.

I absolutely agree with you, being a 'woman of substance' myself, though I can't claim to have been eating healthily the past 2 years. Since I went back to work, my body's been normalizing again and you know, it's amazing what a consistent sleep schedule, regular healthy meals and regular low-impact exercise can do for a body. I almost /don't/ want to say the numbers, but ... 20lbs in 2 months just from walking to work every day, eating at regular times and omg, sleeping for more than 7 hours a night almost nightly.

But I'm not and never will be /thin/. Size 0? Ha. I was a size 10 at age 12 and I wasn't overweight then at all. At 13 I was 5'3" to 5'4" and 125lbs. I grew 3-4 inches over the next 3 years and put on 25lbs as I also matured from girl to woman.

Until my thyroid broke in my 20s, I settled into a healthy 150-165lbs for a medium to large-boned frame with 5'8" height. But I too was labeled fat, in spite of a healthy, moderate diet made up of all food groups and plenty of exercise. I was strong, I was healthy and I had maintained flexibility from doing ballet when I was younger.

I look back at my junior high and high school pictures and I see a normal girl. Not super skinny, but slender enough. But at the time, I thought I was hideously fat and unworthy of any kind of romantic attention because of it.

Now that I /am/ arguably, hideously fat, though I'm pulling away steadily from the dreaded 300lb mark, I wish I could go back and tell my younger self to enjoy life more and not worry so much. Wear the damn bikini in spite of the pot belly.

Anyway, on wellness - on the one hand, I'm in favor of health care promoting healthiness and prevention of problems because I do believe that it's part of the issue in our health care system. By turning everything into a medical problem and focusing on treatment, costs are driven up. However, I also agree that arbitrary ranges of weights and so on are not good indicators of wellness. When I think of wellness, I think of regular check-ups and conversations with a physician about a holistic view of health, not one that exists in such a narrowly defined realm.

Go figure though that we want to be able to easily quantify the unquantifiable. It's the same thing in the autism-diagnosis world: people want to be able to have easy criteria by which to say, 'yes autistic, no not autistic' instead of the very subjective diagnosis model that is in use today.

The truth is that sometimes, there just aren't any easy definitions and while tests and numbers can help to /support/ a diagnosis, losing the holistic view is not necessarily a good thing.

Anonymous Charlie O said...
Good post Jill. As I've posted here before, I'm a triple X myself . Like you, I DO NOT eat fast food, do not eat snack food (OK I do have some oatmeal cookies at home). My knees are shot (bad arthritis) which makes exercise difficult. However I do walk as much as I can.

I've been large my entire life. I was 12 pounds at birth. I've restricted my calorie intake as much as I can, weight loss just doesn't seem to follow.

When I was younger I did drugs. (meth, cocaine). That seemed to keep my weight under control in my 20s and 30s (Now in my 50s). The police will break down my door and kill me and my dog if I go back to that lifestyle, so what's the answer for meeting their "guidelines"?

Blogger Jayhawk said...
Well, it isn't just about health. I'm fortunate in that while I have more than 40% of both lungs destroyed by emphysema, several cardiac arrythmias, have survived half a dozen minor strokes and have had Parkinson's disease for six years now, I function better than the average 70-year-old. Even though my physical activity is, of necessity, somewhat limited and I weight about 30 pounds more than a 6'4" guy my age is supposed to.

What is required to manage all of that stuff? I take a few pills every day, and I see the doctor twice a year, at which point he shakes his head and says, "I don't know how you do it. See you in six months" He does not bug me about my weight.

Anonymous Anonymous said...
In the 1970s, I was diagnosed with adult onset type II diabetes. I gave up sugar, alcohol and lost 80 pounds.
Late 1980s, I was diagnosed with high cholesterol. I gave up beef and cheese.
In the late 1980s, I was diagnosed with high blood pressure and gave up cigarettes and salt.
In the early 1990s, I was diagnosed as "grossly overweight."
I looked the doctor in the eye and said, "Quite frankly, I'd rather be dead than doing so much for my health, my life has basically turned into sheer freaking hell in the last 20 years. No more."
Violate every single rule they made for me. I'm sixty and if I die in a year, I won't be craving a cigarette and a beer. Screw 'em.

Anonymous ShortWoman said...
300 calories a day isn't a weight loss plan, it's starvation. Anything under about 1200 per day is starvation. Look, I know we disagree about optimum weight, but let's agree that 300 calories a day is NUTS. Your body thinks it's smarter than you, and it will slow your metabolism to survive what it is sure must be a famine. After all, why the hell else would you eat that little?? Moreover, most of the diet plans and products out there are primarily for the purpose of lightening your wallet.

If the "health care reform" bill wants to seriously address obesity -- which is a problem -- then it needs to address food additives, food safety, GMOs, the school lunch program, neighborhoods built without sidewalks, and a whole bunch of other sacred cows.

Sincerely, someone 4'11" who still enjoys quality meats, cheeses, the occasional chocolate, daily workouts, and oh yes a good martini on a regular basis.

Blogger Interrobang said...
I'm 167 cm tall almost exactly and weigh a substantial 68kg. That said, I might be the most sculpted "overweight" person you ever saw. Sure, I still have a potbelly on my lower abdomen, but the muscle definition on my upper abs and back is clear as day. I exercise, lift weights, and eat reasonably well. I won't say I never hit the chocolate or candy, but I'm also not sitting there every night with a pint of Haagen-Dasz. (I'm allergic to milk, so good luck with that.)

According to the BMI, I'm "overweight," but the BMI is a crappy tool when aimed at a female weightlifter. That said, if you want to get fat off, you need more lean muscle mass (which burns more calories just existing than does other kinds of tissue), and lifting weights is a great way to get there. Don't be shocked if at first your weight goes up even as your clothing size goes down, though. (Regular exercise also keeps arthritis pain under control, which is why I've gotten hardcore about exercise in the last few years -- I can either suffer for an hour or two every day or two, or I can suffer all the time. Some choice.)

Also, weight-lifting boosts your bone density, which is a must for a lot of women.