Sunday, February 6, 2011

The Obese Mind

(This post is all over the place... My apologies in advance...)

It's flattering to hear people say things like "Look how skinny you are!" or "Oh my gosh!  You're going to wither away if you dont stop losing weight!" or "Dont lose too much weight!" or, my favorite, "You look great!".  But, when I look in the mirror, I see the same person I was at 240lbs.  That image hasnt changed.  Sure, I know I've lost 46 pounds.  I can feel it in my clothes (and in needing to buy new clothes).  I can feel it when I walk around.  I can tell by how much easier it is to bang out a 6 mile run, even in the winter, versus what it used to feel like when I ran a mile or two.  So, I know it's true.  I know I've lost weight.

But in my head, I'm still fat.  Really fat.

This has really made me think.

If I had the opposite problem and suffered from anorexia or bulimia, this would be a problem immediately addressed.  I'd be classified as sick; the DSM IV lists this as an illness.  I could utilize my insurance and go for treatment.  Although binge eating is being considered for inclusion in the DSM, right now there is no over-eating disorder.  Does anyone else see a problem with this?  If you abuse your body to stay thin, you are sick and we want to help you.  If you abuse your body by being obese, we blame you.  You could stop.  You could lose weight if you wanted to.  You choose to be fat.  Many insurances dont even offer reimbursement for gym memberships (with usage of course!) and a fair amount dont cover consults with nutritionists.

I was talking to Peter about this and he said, "But you can stop.  You prove that."

Do I?  Really?

I'm not the only one confounded by the fact that obesity isnt included as a mental disorder.  It's being talked about and it should be.  One of the quotes that really struck me was "Consideration of the mental component of obesity should be a key target in the treatment of obesity to facilitate compliance and minimize relapse."  Can we have that in normal person speak?  We should realize that how overweight and obese people think plays a big role in how they eat.

I struggle.  Every. Damn. Day.  If my feelings are hurt...  If I am stressed...  If I am sad...  I want to go to the kitchen.  No, I feel like I NEED to go to the kitchen.  To rip the pantry apart and eat, eat, eat.  Sweet, salty, I dont care.  Just eat until I can eat no more.  Decimate the candy dish.  Drink the case of soda.  Is think it is safe to say that the above article may hit the nail on the hid by saying some causes of obesity can be linked to food addiction? Right on, doc.

Notice I say "some".  There is a huge debate (amongst docs and those of us in the overweight/obese camp too) about labeling obesity as a brain disorder or a mental illness.  Some people argue "I'm fat- not a nutcase!" while others are begging doctors to see their obesity as the outward sign of something wrong on the inside.  As Peter said while I ranted this afternoon, "There are too many causes of obesity to make it just a mental issue."  And he's right.  By making obesity in the simple "your BMI is too high" fashion a mental illness, we are missing the bigger picture.  Some people may be fat because of medication, because they simply like to eat and dont care if their weight balloons up, or because of a genetic issue.  Some women are heavier because of PCOS and thyroid disease and metabolic issues.  Some because they put on a lot of baby weight and never lost it.  Yes, there are plenty of reasons why.  Plenty.  As many as the stars in the sky.

But some arent.  Some eat because they are sad.  Because they are hurt.  Because they have no reason not to.  Sure, maybe some of the other things play in, too.  But there is a mental component to these people, and that cant be discounted.  

Would I have gone to the gym and changed my lifestyle if someone from my insurance company told me they'd foot the $50/month membership fee?  Probably not... If I'm honest, I'd have said "SURE!" and then, after a month or two, I'd have lost interest and given up.  Now, because I'm the one working out 3-4 times a week, I'm harassing my insurance company to see if they'll pick up the tab as a preventative treatment.  Obesity has a lot of health risks associated with it; among them high blood pressure and high cholesterol.  In the last 4-6 months, I went from having 3 prescriptions a month to 1 (and that's for my Hashimoto's which, in all likelihood, will never go away).  I went from needing injections that cost over $2K a pen just to ovulate and needing the intervention of an RE to try and get pregnant, to ovulating, menstruating, and (even though it ended in miscarriage) getting pregnant on my own.  I'd say these are some significant savings to my insurance company and well worth them picking up my $600 annual gym price tag.  On top of that, the long term outlook of someone within normal weights is significantly better than that of someone overweight or obese.  But my fatness wasnt a big deal...  My doctor mentioned that my weight was high (and that I would be better off losing some), that my BP and cholesterol were high, blah blah blah, here's a pill to help those and, if you'd like, we can give you a pill to help with your weight too.  I saw commercials for Jenny Craig and Weight Watchers and this miracle weight loss treatment.  How I, too, could be bikini ready in a few short months on this pill or using this machine or that one.

Because, really, being skinny or fat- we think it's all about how we look.  I want to look better.  I want to fit into those jeans or shop at that store.  I want to be pretty.

What happened to being healthy?  What happened to our doctors wanting us to be healthy (and not pill reliant)?  Why are insurance companies more than willing to cover a bevy of pills but not a gym membership?  Why will they cover god-only-knows the chemicals in some of those prescription diet pills but not consults to nutritionists?  (Let it be said that, while I am asking these questions of insurance companies in general, we do have coverage for nutritionists, mental health professionals, and (possibly!!) gym reimbursement, so I realize that we are very fortunate, but that isnt the case for a vast majority of people).

I remember going to the doctor quite a number of months ago.  My GP was out and so I saw the CPA who told me how she could help me get this great shake-detox-supplement thing to take off my weight.  It worked for her!  I took the card she gave me and looked it up online.  Really?  You're from my doctor's office and your pushing this non-FDA approved (not that that means anything), not really tested, drug-wannabe?  Really?  I blew it off and thought nothing of it.  Now, mind you, I love my doctor and I love the nurses who, when they gave me my recent blood test results, celebrated that my cholesterol was normal and that my sugars were healthy, but it still rubs me the wrong way that someone in their practice thought hawking that crap was okay.

I dont know what would have helped me.  I really dont.  For me, it was realizing that I couldnt go on this way... That I couldnt keep blaming something else for the simple fact that I ate too much and wasnt exactly eating the best things.  That Bobby and Maya were going to look to me for their example of how and what to eat, and I was a crappy example.  That I needed to "woman up" and be a better mother.  That I didnt want them having the same issues with food that I have.

It's hard because I think that people look at me now and think that I'm somehow cured.  That it was as simply and as easy as counting calories and exercising and, wow, look-ee there, she's lost weight!  But it isnt.  It's a constant struggle.  Not eating well- that's actually the easy part.  And the portion control?  Now that I know it, it's easier too.  And I dont feel sick after eating, so that's a great thing.  But the emotional part?  The part that "feels" obese?  The part that still aches to cram as much food in my mouth as I possibly can when someone hurts my feeling?  Still there.  I can have one cookie and walk away because I know now that I dont need to eat the entire box, but (for now at least) the feeling of "needing" food in my darker moments is still there.

And I fight them, every single time.  And maybe that means I've won the war and I really am "cured".  Or, maybe it means that I'm only winning the battles as they come.

But that's still something.

And I'll take it.


one-hit_wonder said...

2 thumbs up.

Rose said...

I fully understand you and am full of respect for what you achieved already.

And really, it is always a mental issue (at least part of it) when it comes to judging weight.

When a obese person says he/she doesn't want to live unhealthy anymore it is "good". When someone like me (underweight since birth,I'm burning my food too well apparently....noone knows why) says, I am rather a bit skinny than a bit overweight people stare at me.....but it is healthier, sorry!

In my teen years this really showed. with twelve everyone thought I was a scrawny girl....with thirteen i suddenly became anorexic in everyones eyes.

As a angsty teen I suffered from always being "accused" of having a addiction (I mean, it is NOT very nice) but it made me stronger.

I would love to gain a bit (maybe up to 10 pounds) but not necessarily more. I eat healthy (also frowned upon....oh the hypocrisy!) with the occasional fast food thrown in.

I think you did it exactly right. You changed for YOU and your family, others will always have a say about your appearance, but it doesn't really matter as long as you are healthy and like yourself.

And after all you've been through, to go and fight your weight and your lifestyle is truly IMPRESSIVE.
I am proud of you (sorry if that sounded creepy :) )

Mrs.Hunt2006 said...

I'm an emotional eater as well. Taking clomid on top of that really doesn't help that fact. I guess the thing that motivates me is knowing that doing something about it will make me healthy. I want to be healthy for those future babies. But it's still so hard to stay focused, even though I know the goal I want. So I agree this type of eating is a disorder, but people still blame the person. until something magical happens in the medical world, I fear that it will always be.

Tara said...

Your last few posts about losing weight and struggling with obesity have really rung true with me.

I also have lost babies. I also have PCOS. I just recently had gastric bypass, and am doing well overall now, but still have that "fat" mentality now too.

I REALLY feel there are mental and physiological triggers. I feel liek the surgery turned off a switch that allows me to be more "normal" with my food. But the truth is, if I could eat more, I would...that's the mental part, I want more.

I'm learning to live with all of this too & I recognize your struggle.

Kakunaa said...

I think this is a fantastic post - it addresses a very real issue for a lot of people. And I'm proud of you for being "out" about it. HUGS

April said...

I understand exactly what you mean. When I look in the mirror, I don't see me. I see pieces and parts and ignore the rest. When I go shopping, I pick what camouflages me the most. That way, I can hide more. I understand the desire to go and just raid the kitchen and it's a struggle to not eat the bag of chips, the left-overs, the second, third, or fourth helping just because it's there. I'm here with you on the struggle.

Barbara said...

Brilliant post Michelle.


Diana Rose said...

Hey, I have recently discovered in 2011, that I have hypothyroid. I guess it would make sense for me since I am like 10 or 15 lbs overweight. I am now on natural bovine thyroid . I hope it will work for me.

S said...

Great post! I have a friend who takes part in over-eaters anonymous type meetings. It is so evident that our environments, are life experience and our genetics all play a part in our relationship with food. I think you are 100 percent right when you say that people who are overweight may be suffering from the same type of mental thoughts that create anorexia and bulimia. And just as those diseases wreak havoc on our health, so does compulsive overeating. Just wanted to say how well written your posts are. And I'm happy for you that you have been able to tackle this battle. <3

AK said...

This is a great accomplishment, and which could be life-changing!

You may still fret about your appearance or worry that your weight is "not ideal". But the fact is that you got out of the really dangerous zone of obesity.

Maybe rather than worry about how you are going lose still more weight, consolidate your accomplishment by vowing never to go back to the past. For example, "draw the line" at 200 pounds.

I have my own "number" which is the weight I don't want to exceed, so if I start to creep upward toward it, I know I have to eat less calories and spend more time riding my bike. It has not been hard to keep below my desired weight, but I think it would be hard to go a lot lower than where I am now.