Sunday, June 29, 2008

If you live in Scotland, you'd better not be fat

Because if you are, according to the Sunday Herald, your doctor can prescribe Accomplia (generic name: rimonabant) if you haven't "responded to other treatments"--i.e., if you're still fat despite his/her best advice.

That's because Scotland has gone completely bonkers on the subject of fat. Especially when it comes to the children. According to a spokesman for the Scottish National Health Service, "Being overweight or obese during childhood can lead to physical and mental health problems in later life, such as heart disease, diabetes, osteoarthritis, back pain, low self-esteem and depression."

Maybe he hasn't seen this study on how feeling bad about your weight is much worse for your health than actually being fat.

Accomplia, on the other hand, has been linked to depression and other mental health issues, heart attacks, and suicide. Sounds like a perfect "fix" to me.

Thankfully, not everyone in Scotland has leapt onto the anti-obesity train. The Sunday Herald quotes Dr. Ken Paterson, chairman of the Scottish Medical Consortium, as having said, ". . . our advice is that [the drug] shouldn't be used. . . . People regain weight very quickly when they come off this drug, so the real question is what is the benefit of having a short-term, non-sustained weight reduction? We don't believe it should be in general use."

I worry, I really do, about what life will be like here and elsewhere in 10 or 15 years if you're fat.

13 comments:

Vickyann said...

Another miracle cure but scotland won't be decieved. It's an awesome place, I travel there twice a week with work. The Scots I work with are morethan aware their national foods aren't the healthiest - Irn Bru, Tennants, anything deep fried!

They need more health resources not pills.

Vx

Sarah said...

Sometimes, I feel like us fatties are the eugenics project of the 21st century. Anything to make us "better" for the "good" of society, I guess.

MyUserNameReadIt said...

omg..

It's Scotland!!

Aren't they usually built a bit more rounder? Not to be taken in a bad way, I mean, really.

welshwmn3 said...

"Accomplia, on the other hand, has been linked to depression and other mental health issues, heart attacks, and suicide. Sounds like a perfect "fix" to me."

Well, of course it is. The more fatties that die (from suicide of course) the more they can 1) blame suicides on ZOMG!!11!! TEH FATZ! and add that onto the 'life threatening' consequences of being fat, and the less fatties they actually have to look at. It's a win/win situation from that standpoint.

*rolls eyes*

ja said...

Obviously, some people take the anti-obesity war too far, but I also think it's wrong to deny that obesity is a real problem. There is growing evidence of a link between poverty and obesity. Those who are poor are more likely to be obese. By ignoring the problem, you're being insensitive to issues facing the poor.

Why do we think in such polarizing terms? When someone talks about anorexia or bulimia people go, "But waiiiitttt! We need to address the problem of obesity! People are getting to fat!" On the other extreme, when someone tries to address the obesity issue, people start saying, "Noooo! We're encouraging anorexia/bulimia. Obesity isn't a big deal." I think BOTH of those issues are a big deal. A girl I went to school with died of anorexia. My friend's father recently died of health complications from Type II diabetes because he was obese. It goes both ways. We shouldn't address one issue at the cost of ignoring the other issue.

Here's a radical idea. Why don't we start showing concern for both issues?

Harriet said...

Because, ja, eating disorders are diseases, while obesity is not.

When did obesity rates in the U.S. begin to rise? When the low-fat craze first hit supermarket shelves with a vengeance. The more we try to make people thinner, the fatter they have gotten. Diets don't work for 90-some percent of people (I'm talking long-term--5 years out).

That's where fat acceptance comes in. And yes, it is ironic, but by accepting that people come in all shapes and sizes, by accepting that some people are fat, by emphasizing health at every size, I think people would be healthier. And probably thinner.

Anonymous said...

Wow, I just read the side effects and why Accomplia has not been approved in the U.S. One person in the clinical trial attempted suicide. Another tried to kill his daughter. But what's a little mental illness side effect when you've got a spare tire? Very sad. I think this is precisely the danger of thinking of obesity as an "epidemic"--these kind of dangerous solutions seem to make sense.

The linkage between poverty and obesity has to do with a lack of access to health care and to affordable fresh foods. Those are social justice issues not fat issues.

IrishUp said...

JA - obesity and poverty are causally associated, but it's being POOR in economies where the POOR rely on industrial food and cant afford a diverse & nutritious diet that causes health problems related to nutrition. It's not "teh fatz" per-se, but lack of fresh, unprocessed, diverse foods that is the problem. Poverty in-and-of-itself is also life shortening and life-threatening.

So, an appropriate framing of the whole problem might be "how can we make sure that everyone has appropriate nutrition, medicine, health care, and social services?"
But then, that's also a harder question to answer than "How can we exploit fat people?" or "How can corporations make more money from the FAT SCARE?".

Harriet said...

And let's not forget the effects of stress on people's health and well-being. It's hard to overestimate just how stressful it is to be poor in this society.

IrishUp said...

Absolutely Harriet. What I meant was that in public health studies, poverty is an independent predictor of excess mortality and morbidity even when you account for all of the ways in which being poor might be bad for your health. To give specific examples - poor people don't see doctors until it's an emergency. Yet they die younger and have a higher disease load even when compared to more wealthy people whose health care practices are similar. Poor people in the US often have poor nutrition. Yet they have worse outcomes than wealthier people who have similar nutritional habits.
Many of the researchers studying this believe that it's the stress of being poor - the uncertianty, the marginalization, the stigma, the disenfranchizement - that is the added factor.
Hmmm ... sorta like it might not be "teh fatz" (oohhh, I love that, hope u dont mind WW3, I'm stealing it!), but the stress from the social marginalization etc. that is responsible for the added morbidity and mortality.

Hey! I know! :: lightbulb --> on:: Treating people Badly is ... BAD for THEM!

ja said...

You misunderstood me. I never meant to imply that obesity "causes" poverty. I was basically trying to say the same thing you were, which was:

"obesity and poverty are causally associated, but it's being POOR in economies where the POOR rely on industrial food and cant afford a diverse & nutritious diet that causes health problems related to nutrition. It's not "teh fatz" per-se, but lack of fresh, unprocessed, diverse foods that is the problem. Poverty in-and-of-itself is also life shortening and life-threatening.

So, an appropriate framing of the whole problem might be "how can we make sure that everyone has appropriate nutrition, medicine, health care, and social services?"

Those were the points I was trying to make irishup. We both agree it's a social justice/public health issue. Where we differ is our stance on fat/obesity acceptance. I think fat acceptance is a good thing BUT you can have too much of a good thing sometimes. I worry if we go too far with “fat acceptance” we’ll reach the point where we're sugar-coating social justice issues like unequal access to quality schools, lack of health care, lack of access to quality foods, children living in dangerous neighborhoods who don't have the luxury of playing outside, and generally the stress of living in poverty.

Let’s say little Jenny lives in the ghetto with her single mom who works two minimum wage jobs and doesn’t have time to supervise Jenny and make sure she’s exercising and eating healthy. Jenny goes to a terrible public school and reads below grade level. After school, she eats processed food from the cheap store down the street and watches TV. It’s too dangerous to play outside because there are drug dealers down the street. Thanks to these circumstances PLUS the stress of being poor, Jenny becomes morbidly obese. Am I going to ignore the terrible circumstances of her life and just chirpily say she’s beautiful? Ummmm, NO. It’s her crappy, unfair life that made her larger than her natural size in the first place. I’m not going to glorify that in the name of political correctness. Poverty SUCKS. If you blindly accept obesity/fatness ALL the time, you’re accepting the social justice issues that made them obese in the first place. I don’t think people look at photos of starving Africans with their bones sticking out and think, “Wow, they’re really beautiful no matter what.” Most people including myself, would think, “That’s horrible! They look sickly! They need to EAT!” Likewise, when I see poor people who are morbidly obese I’m not thinking, “Wow, that’s beautiful.” I’m thinking, “That’s horrible! They look unhealthy! They need access to health care and good food! They need better economic opportunities and social services!”

Obviously, "fat camps" and anti-obesity laws, and fat discrimination are WRONG. BUT that doesn’t mean people should be afraid to say that OBESITY is dangerous.

ja said...

You misunderstood me. I never meant to imply that obesity "causes" poverty. I was basically trying to say the same thing you were, which was:

"obesity and poverty are causally associated, but it's being POOR in economies where the POOR rely on industrial food and cant afford a diverse & nutritious diet that causes health problems related to nutrition. It's not "teh fatz" per-se, but lack of fresh, unprocessed, diverse foods that is the problem. Poverty in-and-of-itself is also life shortening and life-threatening.

So, an appropriate framing of the whole problem might be "how can we make sure that everyone has appropriate nutrition, medicine, health care, and social services?"

Those were the points I was trying to make irishup. We agree it's a social justice/public health issue. Where we differ is our stance on fat/obesity acceptance. I think fat acceptance is a good thing BUT you can have too much of a good thing sometimes. I worry if we go too far with “fat acceptance” we’ll reach the point where we're sugar-coating social justice issues like unequal access to quality schools, lack of health care, lack of access to quality foods, children living in dangerous neighborhoods who don't have the luxury of playing outside, and generally the stress of living in poverty.

Let’s say little Jenny lives in the ghetto with her single mom who works two minimum wage jobs and doesn’t have time to supervise Jenny and make sure she’s exercising and eating healthy. Jenny goes to a terrible public school and reads below grade level. After school, she eats processed food from the cheap store down the street and watches TV. It’s too dangerous to play outside because there are drug dealers down the street. Thanks to these circumstances PLUS the stress of being poor, Jenny becomes morbidly obese. Am I going to ignore the terrible circumstances of her life and just chirpily say she’s beautiful? Ummmm, NO. It’s her crappy, unfair life that made her larger than her natural size in the first place. I’m not going to glorify that in the name of political correctness. Poverty SUCKS. If you blindly accept obesity/fatness ALL the time, you’re accepting the social justice issues that made them obese in the first place. I don’t think people look at photos of starving Africans with their bones sticking out and think, “Wow, they’re really beautiful no matter what.” Most people including myself, would think, “That’s horrible! They look sickly! They need to EAT!” Likewise, when I see poor people who are morbidly obese I’m not thinking, “Wow, that’s beautiful.” I’m thinking, “That’s horrible! They look unhealthy! They need access to health care and good food! They need better economic opportunities and social services!”

Obviously, "fat camps" and anti-obesity laws, and fat discrimination are WRONG. BUT that doesn’t mean people should be afraid to say that OBESITY is dangerous.

ricki said...

Hrm. Anyone remember the Bed of Procrustes? Where if people didn't fit, their feet got chopped off, or if they were too little, they got stretched on the rack until they fit.

A lot of these "obesity solutions" bring that image to mind: "Here, take this pill to make yourself thin. Yes, it blocks the pleasure centers in your brain. Yes, it might make you suicidally depressed. But you won't be fat any more!"

Bah. (Crosses Scotland off of "list of countries I might consider moving to someday")