Chapter 6: Sexual Health - Theories, Models, and Interventions Flashcards
What does society think of when they see the words fat or obese vs. obese?
Fat: Lazy, greedy, ugly
Obese: Unhealthy, blame-worthy
Thin: Fit, healthy, successful, motivated, strong
Origin of obesity>
Obedere: To devour, eat up; that has eaten itself fat
Obesus: Fat, round, plump
What is an epidemic?
Widespread occurrence of infectious disease
What is BMI?
- What does it measure?
- What does it fail to measure?
1) Body Mass Index (BMI)
- Developed by insurance companies
- Never meant to be a predictor of health; just a way to charge people with high BMI
2) Measures weight to height
3) Fails to measures
- Disabilities
- Natural bodily differences
- Centers white “thin” cis-gender as normal (the baseline)
Obesity Epidemic???
Obesity as a disease is a taken-for-granted assumption
- Ex. Car accidents, poverty
Correlation vs. causation & Populations vs. individuals
- Cannot use statistics at an individual level
The effects of weight based stigma
“From the moment a fat person awakens in the morning, [they are] reminded of living fatly in a thin-centric world. Shower stalls in which we have to stand sideways; towels that won’t fasten around our waists or chests; disproportionately expensive or ill-fitting jewelry, belts, shoes, and clothing; narrow doorways, hallways, aisles, and bathrooms; too-tiny and/or molded plastic seats in buses and on subway trains; narrow, flimsy, or armed office, lawn, theater, airplane, restaurant, and dining room seating; weight limits on exercise equipment; hospital gowns, blood pressure cuffs, MRIs, life jackets, seatbelts, and other health and safety devices that simply don’t fit; all are constant reminders that fat persons don’t fit, that our most basic needs, desires, and safety therefore matter less” (Owen, 2012, p. 294)
What are the effects of weight based stigma?
- Negative impacts on physical and psychological health
- Internalized shame, self-loathing, depression
- Health-seeking behaviours (Less likely to seek help and preventative screening)
- Bias among healthcare o Small chairs with arms, MRI’s, clothing; Patient told to lose weight to access these medical devices)
- Fat people make less money (Fat women make less money than thin women)
- Fatness is related to poverty (Living in poverty is related to being fat)
Note from Katie…
Epidemic: Widespread occurrence of infectious disease
Implies that moving from a BMI of 29 to 30 is comparable to contracting an illness
Ppl just pick up and use the language of epidemic. We are heavier. Also living longer. In 2000 the WHO released a repoty which constructed obesity as a global epidemic
In 2013 the American Medical Association asked its Committee on Science and Public Health to explore the issue of classifying obesity as a disease. They said it should not be, for several reasons:
Obesity doesn’t fit the definition of a medical disease, it has no symptoms and it’s not always harmful – for some people, it’s been protective, rather than destructive
Disease, by definition, involves the body’s normal functioning gone wrong. But many experts think obesity – that is, the body efficiently storing calories as fat – is a normal adaptation that has held tru for much of history
There are correlation but NOT causation links between obesity and illness and obesity and mortality
Medicalizing obesity could potentially hurt patients, creating even more stigma around weight and pushing people into unnecessary and ultimately useless (OFTEN risky) treatments.
The AMA membership didn’t agree with the committee and voted to recognize obesity as a disease (leads to more payouts – doctors who mention weight to their patients could charge more for the same visit than for those who don’t)
And guess what, research has shown that obesity statistics began to leval off around 2000
IF we want to talk about the aribitrary nature of BMI, in 1997 a panel of medical experts for the National Institutes of Health voted to lower the BMI cutoff for overweight from 27 (28 for men) to 25. overnight, millions became overweight and thus eligible for treatment.
The panel was lead by Xavier Pi-Sunyer who had a long history of taking money from weight loss industries
So what is the obesity epidemic? It’s a moral panic. It is a tool of social control
Indeed the construction of an obesity epidemic is evidence of oppression directed at specific groups of people
Anti-fat messaging
- “Obesity Myth” Book at the Public Library but found between “fat” and “losing weight books”
- Weight loss poster at doctor
- Hi I’m Skinny Sticks – food brand
- Magazines
- It is everywhere!!!
*Impacts on physical, mental, emotional health
What is weight cycling?
90 – 95% of diets fail after one year
Industry?
- Canadians spend ~ $7 billion per year on weight-cycling
- The health hazards of weight-cycling
- The hazards of weight-loss products (e.g. liver failure)
- Weight loss surgery (WLS)
Case Studies - Doctors that treat “fat” rather than looking at the medical condition the patient came in for…
Sarah Bramblette nearly lost her mobility due to undiagnosed lymphedema
Cindy Miller lost her life. She carried a pituitary tumor in her head for 18 years, a tumor that disrupted vital hormones and forced a steady and progressive weight gain. She was unable to get effective treatment because no one bothered to make medical equipment big enough or sturdy enough to support a woman of 300 pounds. She had to put up with a lot of doctors shaming her about her weight. She had to hunt down a CAT scan machine that could accommodate her. she had to find a company that rents oversized hospital beds, and convince the hospital to rent one. She had to overcome the surgeon’s reluctance to operate on her. Cindy came through the surgery without a hitch, but a blood clot lodged in her lungs, and efforts to save her failed. The doctors told me such clots are more common in large patients. They couldn’t tell me why no one bothered to take aggressive action to prevent them. No one helped her get up and around after surgery;
CiCI Olisa went to her doctor because she was experiencing shortness of breath when she exercised (which was uncommon). It reminded her of a previous health crisis when she developed a blood clot in her leg – her doctor was dismissive – and said “You seem fine…it’s probably your thyroid. Let’s see if we can get your weight under control in the new year,” CiCi asked if she should be screened for a blood clot, since she would be flying the next day. Her doctor said to go on the trip. CiCi collapsed after flight – she had blood clots in her lungs — a pulmonary embolism
Rebecca Hiles: In 2015, Rebecca Hiles had surgery to remove her right lung (lost to cancer) For five years, doctors dismissed her persistent cough and advocated for weight loss to improve her health. When my surgeon told me a diagnosis five years prior could’ve saved my lung, I remember a feeling of complete and utter rage. Because I remembered the five years I spent looking for some kind of reason why I was always coughing, always sick. Most of all, I remembered being consistently told that the reason I was sick was because I was fat.
My doctors treated my fat, rather than investigating the real reason I was sick, and it could’ve killed me.
Health at every size refers too…
- Body diversity is normal
- Health is multi-dimensional
- People of all sizes deserve health and well-being
- Intuitive eating
- Enjoyable physical activity for people of all sizes
Take away
- There are alternative ways to frame body diversity
- All bodies are good bodies
- Fat stigma has negative (physical and psychological) health consequences
- Health at Every Size is a weight-neutral approach to wellness
- “There is no such thing as too fat. The fattest person has a right to be treated with dignity and care.”
Poodle Analogy demonstrated that…
o Dog analogy
o Ideal dog is a poodle
♣ A mastiff losing weight will still never be a poodle
♣ Recommendation for mastiff to lose weight by poodle is false; they will never reach “poodle health”
o Good science is to better recognize and respect others differences
♣ Health at every size
