Today I received the results of the first round of regular health check tests which I mentioned in the previous post. All of my results were within the range of "normal" except for one. That one was, quite predictably, my BMI which is 30.9%.
Personally, I'm not especially bothered that this number is highlighted in red to indicate that it is a problem because I planned to lose more weight anyway. However, I can't help but feel that the HAES (health at every size) movement would take issue with this. If all of my results are okay, why is weight even being tagged as an issue?
What I realize is that this isn't about any sort of personal choice on the part of the health care provider to point at my weight and say, "bad girl!". This is about bureaucracy and a system which looks only at numbers and reaches conclusions. With this type of health care, I'm essentially being judged by a machine rather than by human judgment. The machine prints out a report and if the range of numbers is outside of certain parameters, it prints it in red. If the number is high, it spits out particular advice. If the number is low, it spits out different advice.
When I learned the results, I was not overjoyed or proud or whatever. I know some of the results could likely be better in the abstract (though there is nothing "wrong" with them now). For instance, my fasting blood sugar is 94. That is on the higher end of "normal", but is nonetheless normal. This number isn't on the high side of normal because I'm overeating or eating poorly. It's where it is because I haven't been sleeping well due to knee pain and my stress levels over the past 6 months have gotten higher and higher (due to taking on a new job and various other issues such as living close to a crisis zone). Insulin is affected by these factors in addition to diet.
The bottom line is that there are things I can do which would favorably impact these statistics and things I can't do. I can't instantly cure my knee, and, in fact, my efforts to date to improve it with self-prescribed physical therapy (exercise, bending, baths) have only made it worse and I'm abandoning that line. Right now, the pain gets better if I do nothing rather than do something. If I can't fix my pain, I can't fix my sleep problems.
The other thing which I think would improve my health is engaging in more vigorous exercise. While I walk and lift weights 5-7 times a week, I can't do strenuous aerobic exercise due to my physical fragility. Mainly, this is due to my knee, which barely tolerates the walking I do everyday. My back is generally better, but if I push it too far too fast, I will pay for it. Even now, I'm having some pain from various stretching exercises which create strain on my back. I can't change the fact that I'm unable to do more challenging exercise due to physical pain and damage.
My main concern about the numbers I was going to receive was that they would be poor and I'd feel that I was already doing almost everything I possibly could to have better health. I eat exceptionally well from a nutritional balance viewpoint. Sure, I eat a few treats a day, but I think only a nut job who derives all of his or her self-esteem and a sense of moral superiority from something as trivial as food choices would believe that a few bites of something sweet a day make a huge health difference. There's no way the equivalent of eating 3-5 Hershey's Kisses per day is going to have an appreciable impact on my health when my calories are kept consistently within a range of 1500-2000 the vast majority of the time and I eat a very good balance of nutritious food.
The tests I took validated my sense that I'm generally pretty healthy now, but I had an odd sense of foreboding even getting them because I know that a person can do everything right and still fail. Health is not something you can attain merely by connecting all of the proper dots. You can increase your chances, sure, but there are no guarantees. Each person works with particular predispositions. I'm genetically lucky in some ways since my body fat is hanging off of my behind and belly instead of collecting around my organs and in areas which tend to contribute to Type 2 diabetes. There are people at my weight or lower who have more problems, not because they are making poor choices, but because their body reacts differently.
At the moment, I'm still in limbo on the thyroid concerns that I mentioned in the previous post. I wasn't permitted to make an appointment for a test until after this first round of test results arrived. I still believe this is a precaution, but a seed has certainly been planted that I have cause for concern. I'd like to dig that seed up and throw it away before it grows any further, but I can't do that until I have another test.
Beyond the thyroid test, I've still got to have a pap test and mammogram. These are other tests that I've avoided for years because of humiliating and degrading experiences due to my weight. Last time I attempted to have such a test, the doctor put me on an electronically elevated table which would not move up due to my weight and angrily asked me how much I weighed and reacted with great and overt disgust that she had to move me to an old fashioned table to conduct the exam. Since then, I haven't gone back. Of course, I know that if I don't take such tests, I'm the one who will pay the price, but I couldn't bear to face it again after that.
Even at my current weight (around 185), I approach all medical experiences with trepidation. I am going to have all of the tests that I should have done completed despite my fears and anxiety. I'm scheduled to get the pap test and mammogram as soon as possible (around mid-October). I'm saddened that it took extreme weight loss to work up the courage to do what normal people do to maintain health and I'm angry that negative experiences made me avoid them for so long. As I've mentioned before, I often wonder if the higher mortality rate among obese individuals is related to not seeking regular health care due to the shoddy treatment they receive rather than obesity-related illness. If you don't go until something is seriously wrong, it is likely too late to deal with the issue.
For now though, I'm satisfied that I'm okay on the fronts which have been measured and relieved that doing everything I reasonably can just so happens to be "enough" for all of the machines to say I'm healthy.
Showing posts with label HAES. Show all posts
Showing posts with label HAES. Show all posts
Tuesday, September 27, 2011
Friday, July 29, 2011
How did health become a social responsibility?
At a former job, the president of the small company I worked at once criticized workers for having to call in sick. He said that employees had a responsibility to look after themselves and not impede the orderly conducting of business with their absence. This same man used to take a half day off of work and go home if he had a headache so it was hard to take anything he said seriously given the immense level of hypocrisy that he displayed.
The underlying notion of what he said, however, is becoming increasingly more pervasive. The idea that we "owe it" to others, especially unconcerned strangers or all of society, to care for ourselves in a particular manner is not one that has always been around. Previously, I wrote about how I think that health and how we deal with our own bodies is a personal choice and nobody's business and I pondered today how we have reached a collective mentality which pressures people to attain health, as if it were something we could choose to pursue and successfully acquire (it isn't in many cases, but that is beside the point).
While rolling this notion around in my head, I thought about what life was like hundreds of years ago. Before medical science, people knew that there were certain actions or behaviors which lead to better or worse health and some lived a lifestyle which was more conducive to maintaining health and some less. They did this because health was seen as precious to them and integral to maintaining their livelihood and life. If they became sick, there was little or no confidence that there would be a treatment that would repair the damage or cure the disease.
People during that time also knew that luck played a huge role in whether or not someone was healthy. They may not have known about genetics, but they did know some people were born hearty and some weak and prone to problems. They also realized, all too well, that wealth factored into the availability of food, medicine, and education such that poorer people had a lower chance of living in good health than richer ones. During this time, I doubt that a person who became sick was "blamed" for his or her state (short of those who drank themselves into illness) and certainly was not seen as a burden on society for allowing themselves to become sick. In the past, people wanted health for their own reasons, not because they owed it to their community at large.
So, what happened to our mentality and why did it switch? How did we go from desiring health for our sake to a world which is demanding it for society's sake? I can only speculate, of course, but I think that the following may be factors:
1. The perception that medicine can cure (nearly) anything altered the perception that health was related to luck (genetics, environment, wealth) and transformed it into something we can buy. As we perceive health as something we can choose to purchase or cultivate, we see those who do not attain it as choosing to cost "us" money rather than live a lifestyle that is conducive to health.
2. Media states "you owe it to (whoever)" to be healthy, strong, etc. This notion creates a sense of being obliged to be well. Of course, these messages are commonly offered by companies selling supplements or some other product that promises health, but the messenger's original intent (commercial interests) is lost on people who remember the message but not the source as time goes by. This notion has insinuated it into the collective consciousness.
3. Egalitarian societies which allow for more even distribution of resources lead us to believe everyone has many good choices. In the past, we knew people had unequal access to food, medicine and health education. We didn't expect them to look after themselves well because the perception was they had little choice in the matter.
4. Social welfare created the mindset in which people feel they have a say in your private matters as long as they are paying taxes to assist you. The idea that those relying on public assistance to survive are akin to "employees" who the "employer" (tax-payer) can dictate to is becoming increasingly pervasive.
5. Democracy has an underlying notion of "self-determination" which indoctrinates citizens into the belief that we can do anything if we make the right choices in life. It doesn't provide any context and creates an illusion (which results in just world thinking) that all people have all choices (or at least that the "good choices" healthy people make are available to to everyone). Humans used to understand life was inherently unjust because the evidence was all around them, but that thinking has been replaced. As the material aspects of life have equalized for many people, the illusion that our lives are roughly equitable has created the notion that we all have equal access to health-related choices.
I'm not going to debate whether or not any of this thinking is valid because I've already made it clear in my posts that I think people are far less in control than we'd like to believe. The momentum of personal history drives people to do things another person might not do and our solution is not to help them slow down the car hurtling toward the precipice but to sit by and cluck our tongues in disapproval that they can't get their foot off the gas pedal. In my mind, those people aren't choosing to keep it on there, but their legs are paralyzed and they can't lift their feet. My interest continues to be to help them regain mobility so they can go in another direction rather than to point my finger and accuse them.
I realize my belief that it is far harder to change your choices is an unpopular way of viewing things because it flies in the face of a lot of the thinking I've detailed above. Nonetheless, I think it goes a lot further toward explaining why people continue to do things that hurt them than simply deciding to blame them for their choices. My intention in this post was mainly to explore the factors which I believe have lead us to the point in which we believe health is a social responsibility rather than a personal one. I don't believe that what I do with my body is anybody's business, but that doesn't mean I don't want to understand what drives them to think it is their concern.
The underlying notion of what he said, however, is becoming increasingly more pervasive. The idea that we "owe it" to others, especially unconcerned strangers or all of society, to care for ourselves in a particular manner is not one that has always been around. Previously, I wrote about how I think that health and how we deal with our own bodies is a personal choice and nobody's business and I pondered today how we have reached a collective mentality which pressures people to attain health, as if it were something we could choose to pursue and successfully acquire (it isn't in many cases, but that is beside the point).
While rolling this notion around in my head, I thought about what life was like hundreds of years ago. Before medical science, people knew that there were certain actions or behaviors which lead to better or worse health and some lived a lifestyle which was more conducive to maintaining health and some less. They did this because health was seen as precious to them and integral to maintaining their livelihood and life. If they became sick, there was little or no confidence that there would be a treatment that would repair the damage or cure the disease.
People during that time also knew that luck played a huge role in whether or not someone was healthy. They may not have known about genetics, but they did know some people were born hearty and some weak and prone to problems. They also realized, all too well, that wealth factored into the availability of food, medicine, and education such that poorer people had a lower chance of living in good health than richer ones. During this time, I doubt that a person who became sick was "blamed" for his or her state (short of those who drank themselves into illness) and certainly was not seen as a burden on society for allowing themselves to become sick. In the past, people wanted health for their own reasons, not because they owed it to their community at large.
So, what happened to our mentality and why did it switch? How did we go from desiring health for our sake to a world which is demanding it for society's sake? I can only speculate, of course, but I think that the following may be factors:
1. The perception that medicine can cure (nearly) anything altered the perception that health was related to luck (genetics, environment, wealth) and transformed it into something we can buy. As we perceive health as something we can choose to purchase or cultivate, we see those who do not attain it as choosing to cost "us" money rather than live a lifestyle that is conducive to health.
2. Media states "you owe it to (whoever)" to be healthy, strong, etc. This notion creates a sense of being obliged to be well. Of course, these messages are commonly offered by companies selling supplements or some other product that promises health, but the messenger's original intent (commercial interests) is lost on people who remember the message but not the source as time goes by. This notion has insinuated it into the collective consciousness.
3. Egalitarian societies which allow for more even distribution of resources lead us to believe everyone has many good choices. In the past, we knew people had unequal access to food, medicine and health education. We didn't expect them to look after themselves well because the perception was they had little choice in the matter.
4. Social welfare created the mindset in which people feel they have a say in your private matters as long as they are paying taxes to assist you. The idea that those relying on public assistance to survive are akin to "employees" who the "employer" (tax-payer) can dictate to is becoming increasingly pervasive.
5. Democracy has an underlying notion of "self-determination" which indoctrinates citizens into the belief that we can do anything if we make the right choices in life. It doesn't provide any context and creates an illusion (which results in just world thinking) that all people have all choices (or at least that the "good choices" healthy people make are available to to everyone). Humans used to understand life was inherently unjust because the evidence was all around them, but that thinking has been replaced. As the material aspects of life have equalized for many people, the illusion that our lives are roughly equitable has created the notion that we all have equal access to health-related choices.
I'm not going to debate whether or not any of this thinking is valid because I've already made it clear in my posts that I think people are far less in control than we'd like to believe. The momentum of personal history drives people to do things another person might not do and our solution is not to help them slow down the car hurtling toward the precipice but to sit by and cluck our tongues in disapproval that they can't get their foot off the gas pedal. In my mind, those people aren't choosing to keep it on there, but their legs are paralyzed and they can't lift their feet. My interest continues to be to help them regain mobility so they can go in another direction rather than to point my finger and accuse them.
I realize my belief that it is far harder to change your choices is an unpopular way of viewing things because it flies in the face of a lot of the thinking I've detailed above. Nonetheless, I think it goes a lot further toward explaining why people continue to do things that hurt them than simply deciding to blame them for their choices. My intention in this post was mainly to explore the factors which I believe have lead us to the point in which we believe health is a social responsibility rather than a personal one. I don't believe that what I do with my body is anybody's business, but that doesn't mean I don't want to understand what drives them to think it is their concern.
Friday, July 22, 2011
Why the HAES movement has it wrong
Lately, I've been thinking about the HAES (health at every size) movement. I've run across some fairly articulate fat activists who keep beating readers over the head with their spectacular health at their high weights. This habit has been rubbing me the wrong way, but I hadn't really given it too much consideration until recently.
I realized that my discomfort with HAES as a focal point among overweight people comes from the fact that the very existence of such a movement validates the idea that we have a social responsibility to be healthy. It comes from the same mental place as people who criticize being overweight because it drains the health care system funds or who think it's okay to tell you you're fat and shouldn't eat this or that "because it's bad for your health". Health isn't an obligation we owe the world and HAES essentially acts as an answer to criticisms about weight and health. By addressing those concerns, you validate them.
My feeling is that there needs to be a different sort of movement which encompasses all people with all lifestyles. I'd call it "My Body, My Business." If you want to make it sound catchier, you could even call is "MB squared". The basic idea is that everyone has the right to treat their body, which they own and live in, as they desire. If they want to spruce it up, remodel it, or rebuild it, that's their business. If they want to wreck it or demolish it, it's also their business.
If this were the movement, the focus would be on personal rights to live in accord with ones own values and pursuit of happiness. Those rights, however, would end where they infringe on someone else's. That means smokers can smoke until their lungs turn black, but they can't inflict their smoke on anyone else. It means fat people can gain as much weight as they like, but they can't crowd someone else on a plane. It means alcoholics can drink until their livers cry for mercy, but they can't get in a car and hurt someone else.
Of course, there will always be people who argue that we harm others collectively with our bad habits and damaging our bodies, but I would say that vague and diffuse costs are the top of a slippery slope in which we police lifestyles according to "the greater good". We don't want to go there, because if we kept on that path, no one would be happy when they reached that destination. So, let's keep it to the concrete and real and stop talking about health, which is personal and nobody's business and you don't have to justify how you live to anyone but yourself, and focus on minding our own damn business.
I realized that my discomfort with HAES as a focal point among overweight people comes from the fact that the very existence of such a movement validates the idea that we have a social responsibility to be healthy. It comes from the same mental place as people who criticize being overweight because it drains the health care system funds or who think it's okay to tell you you're fat and shouldn't eat this or that "because it's bad for your health". Health isn't an obligation we owe the world and HAES essentially acts as an answer to criticisms about weight and health. By addressing those concerns, you validate them.
My feeling is that there needs to be a different sort of movement which encompasses all people with all lifestyles. I'd call it "My Body, My Business." If you want to make it sound catchier, you could even call is "MB squared". The basic idea is that everyone has the right to treat their body, which they own and live in, as they desire. If they want to spruce it up, remodel it, or rebuild it, that's their business. If they want to wreck it or demolish it, it's also their business.
If this were the movement, the focus would be on personal rights to live in accord with ones own values and pursuit of happiness. Those rights, however, would end where they infringe on someone else's. That means smokers can smoke until their lungs turn black, but they can't inflict their smoke on anyone else. It means fat people can gain as much weight as they like, but they can't crowd someone else on a plane. It means alcoholics can drink until their livers cry for mercy, but they can't get in a car and hurt someone else.
Of course, there will always be people who argue that we harm others collectively with our bad habits and damaging our bodies, but I would say that vague and diffuse costs are the top of a slippery slope in which we police lifestyles according to "the greater good". We don't want to go there, because if we kept on that path, no one would be happy when they reached that destination. So, let's keep it to the concrete and real and stop talking about health, which is personal and nobody's business and you don't have to justify how you live to anyone but yourself, and focus on minding our own damn business.
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